The spectrum of MEFV gene mutations and genotype-phenotype correlation in Egyptian patients with familial Mediterranean fever

Background: Familial Mediterranean fever (FMF) is an autosomal recessive disease mainly affecting subjects of the Mediterranean origin. It is an auto-inflammatory periodic disorder that is caused by mutations in the Mediterranean fever gene (MEFV) located on chromosome 16.Methods: The current study was designed to assess the prevalence and frequency of different MEFV gene mutations among 104 FMF clinically diagnosed Egyptian patients and to evaluate the change extent in the values of some biochemical markers (ESR, CRP, Fibrinogen-C, SAA and IL1) in different participants with different FMF severity scores.Results: According to allele status 28 patients (27%) were homozygous mutation carriers, 38 (36.5%) were with compound heterozygous mutations and 38 (36.5%) were identified as heterozygous for one of the studied mutations. Of the studied mutations, M694I, E148Q, V726A, M680I, and M694V accounted for 28.1%, 26.8%, 16.9%, and 11.3% of mutations respectively. The R761H and P369S mutations were rarely encountered mutations (1.4%). The clinical features with M694I were associated with more severe clinical course. There is a drastic elevation in the levels of estimated parameters as their levels were increased as long as the severity of the disease increased.Conclusions: The diagnosis of FMF cannot be performed on the basis of genetic testing or clinical criteria alone. So, we recommended the combination between clinical and molecular profiling for FMF diagnosis and scoring

Unveiling the High Prevalence of Antibiotic Resistance and Quorum Sensing Genes in Uropathogenic Escherichia coli

Escherichia coli is considered one of the uropathogenic bacteria with different infection symptoms representing mild illness to acute sepsis. This study aims to detect E. coli in patients with urinary infection and investigate quorum sensing genes (lux S and motA) in multi-drug resistant isolates of E. coli.  200 urine samples were collected from patients with urinary tract infections from several hospitals in Baghdad. The antibiotics sensitivity test showed high resistance of isolates for Ampicillin (100%), Cefazolin (97%), Trimethoprim/ Sulfamethoxazole (83%), Ceftriaxone (77%), Ceftazidime and Ciprofloxacin (70% each of them), and moderate resistance of isolates for Levofloxacin (50%), Gentamicin (47%), Cefepime (40%), while low resistance Piperacillin/ Tazobactam (33%), Cefoxitin (30%), Nitrofurantoin (17%), Imipenem (10%), Ertapenem and Amikacin (7% each of them), and Tigecycline (3%). The results showed an increase percentage of infection in females was 30% in the ages 30-44 years, whereas in ages 15-29 and more than 45 years was 17%.  There was a high percentage (57.11%) of resistant isolates in females which are ages 30-44 years. While the ages more than 45 years were 66.4% and ages 15-29 were 34%. While, in males, the percentage was high in ages more than 45 years (35.25%) followed by age groups 30-44 years (31.5%) and 15-29 years (31%).  The prevalence percentage for luxS and motA genes in E. coli was 100%. In conclusion, E. coli isolates were multi-drug resistant due to all isolates had quorum sensing genes. Moreover, uropathogenic of E. coli in females was more frequent than in males due to the resistance of bacteria to antibiotics.    

Effect of esomeprazole on maternal serum soluble fms-like tyrosine kinase-1 and endoglin in patients with early-onset preeclampsia

Objective: This study evaluates the effect of esomeprazole on the maternal serum levels of soluble fms-like tyrosine kinase-1 (sFlt-1) and soluble endoglin (sEng) in patients with early-onset preeclampsia.Methods: A randomized, double-blind, placebo-controlled trial was carried out in a tertiary University hospital between March 2018, and September 2019 (Clinical Trials.Gov: NCT03213639). The study included women between 28 and 31+6 weeks gestational age who had been diagnosed as preeclampsia without severe features. They were randomly assigned in a 1:1 ratio into an esomeprazole group, which received esomeprazole 40 mg orally once a day, and a placebo group, which received one placebo tablet daily. Blood samples were obtained to assess levels of serum sFlt-1and sEng using ELISA testing. The primary outcome was the difference between the mean serum level of sFlt-1 and sEng at the start of treatment and at the termination of pregnancy in both groups.Results: Eighty-eight patients were randomly assigned into both groups (44 in each). No statistically significant difference was found in the levels of sFlt-1 between both groups at admission and termination of pregnancy. The number of days of treatment for the esomeprazole group was slightly longer than the placebo group (11.4±9.4 vs. 10.3±6.3 days, P=0.515). No statistically significant difference in the rate of maternal and fetal complications occurred between the two groups. No side effects from the study medications were reported.Conclusions: Esomeprazole, at the dosage used in this study did not effectively lower the serum levels of sFlt-1 and sEng in patients with early-onset preeclampsia. Furthermore, it did not prolong the duration of pregnancy, nor did it decrease maternal or fetal complications

Medical students carry more virulent microorganisms at their throat than that of patients' accompaniers

Background: Transition of medical students from a non-clinical to a clinical situation carries a great risk that needs further investigation. This study aims to detect and compare the throat bacterial colonization between medical students and patients’ accompaniers in a tertiary hospital. Methods: Across-sectional descriptive study was conducted at the out-patient clinics of the Baquba Teaching Hospital at the Faculty of Medicine, Diyala University, Iraq.  A total of 120 throat swabs collected from sample of 70 medical students (fifth stage) and 50 volunteers as a control group who were selected conveniently during their outpatient visits over the September 2018. Aerobic  and anaerobic culture methods were recruited to investigate the samples following the standard microbiological procedures. Results: Finding of this study indicate a high rate of bacterial throat colonization among medical students compared to control group. Male gender showed high susceptibility for infection than females. The most common bacteria isolated among medical students were Staphylococcus aureus and Escherichia coli 26 (37.1%), followed by Streptococcus pneumoniae appeared in 23 samples (32.8%), Viridians streptococci 19 (27.1%), Acinetobacter spp. 14 (20%), Enterobacter spp. 4(5.7%), Candida spp. 3(4.2%), Pseudomonas aeruginosa 2(2.8%) respectively. Conclusion: Our findings suggest that medical students may contribute significantly for transmission and dissemination of nosocomial pathogens among patients and vice versa

Medical students carry more virulent microorganisms at their throat than that of patients' accompaniers

Background: Transition of medical students from a non-clinical to a clinical situation carries a considerable risk that needs further investigation. This study aims to detect and compare the throat bacterial colonization between medical students and patients' accompaniers in a tertiary hospital. Methods: Across-sectional descriptive study was conducted at the outpatient clinics of the Baquba Teaching Hospital at the Faculty of Medicine, Diyala University, Iraq.  A total of 120 throat swabs collected from a sample of 70 medical students (fifth stage) and 50 volunteers as a control group who were selected conveniently during their outpatient visits over September 2018. Aerobic and anaerobic culture methods were recruited to investigate the samples following the standard microbiological procedures. Results: Finding of this study indicate a high rate of bacterial throat colonization among medical students compared to the control group. Male gender showed high susceptibility for infection than females. The most common bacteria isolated among medical students were Staphylococcus aureus, and Escherichia coli 26 (37.1%), followed by Streptococcus pneumonia appeared in 23 samples (32.8%), Viridians streptococci 19 (27.1%), Acinetobacter spp.14 (20%), Enterobacter spp. 4 (5.7%), Candida spp. 3 (4.2%), Pseudomonas aeruginosa 2 (2.8%) respectively. Conclusion: Our findings suggest that medical students may contribute significantly to the transmission and dissemination of nosocomial pathogens among patients and vice versa

A brief investigation on the prospective of co-composted biochar as a fertilizer for Zucchini plants cultivated in arid sandy soil

Compost is commonly utilized to improve properties of infertile sandy soils, despite its high biodegradability which may increase greenhouse gases emissions. It is possible to combine compost with biochar, which degrades at a slower rate, forming a “co-composted biochar” product. This mixture could enhance plant growth parameters beyond those attained for using each component, individually. To investigate this assumption, zucchini was selected as a test plant to be grown, under greenhouse conditions, on a sandy soil that received biochar, compost or co-composted biochar (from rice straw or sugarcane bagasse (SB)) for a duration of 15 days. This timeframe was deemed sufficient to achieve a relatively stable degradation rate for compost. Application of organic materials increased both fresh and dry weights of zucchini plants, particularly when co-composted biochar of SB was used. Specifically, plant fresh weights increased by 1.24–1.71 folds when using this additive versus the control group. Additionally, availability of nitrogen, phosphorus, and potassium in soil and their uptake by plants significantly increased owing to application of all additives, with superiority for the co-composted biochar of SB. Enhancements in plant fresh weights were strongly correlated with increasing availability and uptake of phosphorus by plants. In conclusion, organic amendments have a substantial positive impact on enhancing the nutritional status and growth of zucchini, even during the early vegetative growth stage (within the first 15 days after planting). The greatest improvements were observed when co-composted biochar of SB was used and this confirm the main hypothesis of the study

Proanthocyanidin-rich date seed extract protects against chemically induced hepatorenal toxicity

A hydroacetone extract was prepared from seeds of Phoenix dactylifera L. var. Khalas, which is an industrial by-product of date processing. The proanthocyanidin nature of the extract (coded as DTX) was characterized by phytochemical and nuclear magnetic resonance (NMR) analyses. The total phenol/proanthocyanidin content and antioxidant activity of DTX were estimated by Folin-Ciocalteu, vanillin-sulfuric acid, and 2,2-diphenyl-1-picrylhydrazyl (DPPH) assays, respectively. The hepatorenal protective activity of DTX was evaluated using CCl4-induced toxicity model in rats, in comparison with silymarin (SYL). Results of the histopathological examination and measurements of various hepatorenal serum indices and tissue biochemical markers demonstrated that DTX displayed marked protective potential against CCl4-induced liver and kidney injury at 100 mg/kg/rat. Relative to the control CCl4-intoxicated group, pretreatment with DTX significantly (P<.001) suppressed the elevated serum levels of alanine aminotransferase and aspartate aminotransferase (ALT and AST), alkaline phosphatase (ALP), γ-glutamyl transferase (GGT), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), bilirubin, creatinine, and calcium, whereas it significantly (P<.001) increased the diminished serum levels of high-density lipoprotein cholesterol (HDL-C) and total protein (TP). Moreover, DTX significantly decreased malondialdehyde (MDA) formation and increased TP synthesis in hepatorenal tissues compared with the intoxicated control. The improvement in biochemical parameters by DTX was observed in a dose-dependent manner and confirmed by restoration of normal histological features. The acute toxicity test of DTX in rats revealed safety of the extract. This study reveals that DTX enhances the recovery from xenobiotics-induced toxicity initiated by free radicals

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

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe