The Impact of Antiepileptic Drugs on Thyroid Function in Children with Epilepsy: New Versus Old

 Abstract ObjectivesTo investigate the effects of traditional antiepileptic drugs (AEDs) versus newer AEDs on the thyroid hormone profile of children with epilepsy.Materials & MethodsA total of 80 children with epilepsy were included in this study and were divided into two groups. Group 1 included 40 children with epilepsy on traditional AEDs, and group 2 included 40 children with epilepsy on newer AEDs. Forty healthy children were also included as the control group (group 3). We analyzed the serum levels of free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH).Results: Epileptic children treated with traditional drugs showed a statistically significant decrease in the serum fT4 and increase in TSH concentrations compared to the control group (P < 0.001). Whereas epileptic children treated with newer drugs showed no statistically significant changes in the serum fT3, fT4 and TSH concentrations compared to the control group Conclusions: Traditional AEDs have a significant impact in the thyroid hormone profile compared to the newer AEDs

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

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

The effect of licorice (Glycyrrhiza glabra) on peptic ulcer in rats

A peptic ulcer is sore on the lining of the stomach or duodenum; the two most common types of peptic ulcer are celled gastric ulcer and duodenum ulcer. Peptic ulcer are found to be due to an imbalance between aggressive factor such as hydrochloric acid (HCL), pepsin and refluxed bile. As the current study aimed to investigate the protective effect of Licorice against peptic ulcer.Thirty male Wistar albino rats were randomly divided into five groups (n = 6) as follow; -ve control group fed basal diet, +ve control group fed basal diet and injected with a single dose of Ranitidine (20mg/kg/day, bw, p.o.) (7 days). Groups 3-5 fed licorice with 1 ml. once a week, 1 ml. twice a week, 1 ml. three times a week respectively. Results revealed that licorice caused a significant decrease in blood cholesterol level, TG, LDL, AST, ALT, urea nitrogen, uric acid, creatinine, uric acid, albumin and VLDL. In addition, licorice caused a significant increase in HDL and PH, especially in group 5 which fed 3 ml. compared to +ve control group.&nbsp

Physicochemical Properties of Enzymatically Modified Starches

The physicochemical properties of native, annealed and enzyme-treated chickpea (CP), corn (CS), Turkish bean (TB) and sweet potato (SPS) were investigated. Germinated sorghum extract (GSET) was used as the source of enzymes. Starches were annealed in excess water by holding the slurry at 60 °C for 60 min with or without GSET. The flow curves/rheological data were fitted to the power law, Casson and Herschel–Bulkley models. Starches exhibited shear thinning behavior and a variation in the flow behavior index (n) (0.34–0.82) as a function of the starch type. The consistency index (k) of CP and CS decreased with annealing and GSET treatment but increased for TB and SPS. Annealed and GSET-treated SPS exhibited the highest yield stress compared to the other starches, except for CP. The temperature dependency of all starches was well described by the Arrhenius model (r2 = 0.88–0.99). The activation energy (Ea) values were in the range of 660–5359 (J/mol). The TB exhibited the most Ea and SPS the least. With the exception of SPS, annealing appeared to increase the Ea of all tested starches, but the range of Ea was broader for SPS and CS. Annealed and GSET starches exhibited an increase in the gelatinization temperatures (onset and peak) and a decrease in gelatinization enthalpy (ΔH). The syneresis and water holding capacity decreased after annealing or GSET treatment

Evaluation of Different Stabilizers and Inactivating Compounds for the Enhancement of Vero Cell Rabies Vaccine Stability and Immunogenicity: In Vitro Study

Inactivation of rabies virus is essential for rabies vaccine preparation where the inactivating compound that is currently recommended for rabies vaccine preparation is β-propiolactone (β-PL). This compound is considered better than phenol and formalin but it is expensive and potentially carcinogenic. Data revealed that Ascorbic acid (AA) with cupric ions could yield complete and irreversible inactivation of rabies virus without adversely affecting its antigenicity. Additionally, the results of testing the vaccine potency with the selected inactivating compounds were comparable (P<0.05), and ED50 was higher than the recommended World Health Organization (WHO) limits. The use of HemaGel (plasma substitute) for testing vaccine stabilization was compared with the currently used vaccine stabilizers (human albumin and lactose). HemaGel yielded better stability than the other tested stabilizers. Monitoring of cellular and humoral immune responses indicated that both the total IgG level against rabies vaccine and the IFN and IL5 levels obtained with the HemaGel-stabilized vaccines were higher than those obtained with human albumin- and lactose-stabilized vaccine candidates

Citrox Improves the Quality and Shelf Life of Chicken Fillets Packed under Vacuum and Protects against Some Foodborne Pathogens

Natural antibacterial agents such as citrox are effective against many foodborne pathogens and foods contaminated with bacteria. We studied the antimicrobial effects of citrox solutions (1% and 2%) on the total viable counts of methicillin-resistant Staphylococcus aureus (MRSA) in chicken meat fillets. The total coliform group counts found in the chicken samples were also determined. The samples were treated with S. aureus at a concentration of 106 colony-forming units (cfu)/g of meat and vacuum-packed (VP) at 4 &deg;C for 3, 6, 9, 12, 15, 18, and 21 days. We also studied the effect of citrox on the total volatile basic nitrogen (TVBN) content and pH changes during the storage period of the meat samples. The results revealed that citrox inhibited the growth of MRSA in the chicken fillets. The total viable counts of MRSA decreased after treatment with 2% citrox in all treated samples that were stored at 4 &deg;C by approximately 2 log units compared with the samples inoculated with S. aureus (Chicken-Staph groups) after 3, 6, 9, and 12 days of storage, and by approximately 1 log unit compared with the control samples treated with salt (Chicken-Salt groups) after 3, 6, and 9 days of storage. TVBN was reduced in the Chicken-Citrox-treated samples stored at 4 &deg;C compared with the Chicken-Staph- and Chicken-Salt-treated samples. The results indicated that citrox is effective in reducing the total counts of MRSA and in improving the quality of chicken during the first three days of storage by reducing the number of bacteria by 1 log unit and extending the shelf life of chicken

Functionalization of pre-gelatinized Urad bean fermented by Saccharomyces cerevisiae MK-157 as a fat replacer and its impact on physico-chemical, micromorphology, nutritional and sensory characteristics of biscuits

The reduction of saturated fats in baked products has become an important unit operation in the food industry due to the consumers' demand for healthy foods low in saturated fat. In this research, a comprehensive biotechnological technique was explored to enhance the functional, technological, and nutritional characteristics of Urad beans as a fat replacer in biscuits via the combined treatment of gelatinization and fermentation by Saccharomyces cerevisiae MK-157. Fat in biscuits was replaced with fermented and gelatinized Urad bean flour (FGUBF) by S. cerevisiae MK-157 in the following proportions: 10%, 20%, and 30% wt/wt. The peak, final, breakdown, and setback viscosities of flour blends decreased. Protein, ash, crude fiber, antioxidants (DPPH, FRAP, ABTS, hydroxyl scavenging), bioactive compounds (total phenol content (TPC) &amp; total flavonoid content (TFC)), and α-glucosidase inhibition increased, with the level of fat replacement in flour blends and their biscuits. However, FGUBF reduced the ash (4.32%) and fiber (10.96%) contents compared to the control sample (5.11% and 20.32%, respectively). The TPC and TFC of flour blends increased from 35.49 to 90.01 mg GAE/100 g and from 20.83 to 60.45 mg CE/100 g, respectively. However, baking decreased the values of TPC compared to flour blends, whereas TFC increased, and a similar increase in antioxidant activities was observed for fat-replaced biscuits. Phytic acid and total saponins were drastically reduced after fermentation by 98.83% and 98.85%, respectively. The microstructure of biscuits showed disoriented arrangements of protein, starch, fiber, and their complexes with disrupted gluten networks. Fermentation enhanced the In vitro protein digestibility (74.91 to 89.21%) of samples. Biscuits prepared from 20% FGUBF demonstrated desirable dimensional, textural, and sensory properties compared to control biscuits. Based on the results of this investigation, FGUBF might be recommended as an important natural fat substitute with enhanced nutrient bioavailability, antioxidants, and bioactive compounds for functional foods and nutraceuticals

Biocidal Polymers: Synthesis, Characterization and Antimicrobial Activity of Bis-Quaternary Onium Salts of Poly(aspartate-co-succinimide)

Microbial multidrug resistance presents a real problem to human health. Therefore, water-soluble polymers based on poly(aspartate-co-succinimide) were synthesized via reaction of poly(aspartate-co-succinimide) with bis-quaternary ammonium or quaternary salts. The resultant copolymers were characterized by various techniques such as FTIR, TGA, 1HNMR, 13CNMR and elemental microanalysis. Antimicrobial activities of the new onium salts were investigated against Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and Salmonella typhi, and the fungi; Candida albicans,Aspergillus niger, Cryptococcus neoformans and Aspergillus flavus by agar diffusion method. Antimicrobial activity was studied in terms of inhibition zone diameters, in addition to the estimation of minimal inhibitory concentration (MIC) of the prepared compounds. A. niger and E. coli were the most affected microorganisms among the tested microorganisms with an inhibition zone of 19&ndash;21 (mm) in case of biocides, (V) and (VII). The obtained results showed that the quaternary onium salts have higher activity compared to the aspartate copolymer with MIC concentrations of 25 mg/mL for (VII) and (V) and 50 mg/mL for (VI) and (IV)

Techno-functional, antioxidants, microstructural, and sensory characteristics of biscuits as affected by fat replacer using roasted and germinated chickpea (Cicer arietinum L.)

ABSTRACTObesity is one of the major causes of non-communicable diseases (NCDs) associated with a dietary pattern rich in saturated fat. The present study utilized roasted and germinated chickpeas (Cicer arietinum) flour (RCPF and GCPF) as a replacement for fat in biscuits, known to have nutraceutical properties. The fat content was modified using the following ratios: 10%, 20%, and 30% (w/w) of RCPF/GCPF. Based on the physicochemical analysis, increased concentrations of RCPF and GCPF in the flour blends resulted in higher levels of protein, ash, and crude fiber contents. GCPF was found to contain higher levels of protein (20.20%), ash (4.86%), and crude fiber (3.64%) compared to RCPF. Increased RCPF and GCPF levels resulted in reduction of gluten content, which indicated weak gluten network. Scanning electron micrographs (SEM) of biscuit samples further supported these observations. The farinograph properties showed significant increase (P<0.05) in water absorption and dough development time. Furthermore, when RCPF and GCPF were added to flour blends and biscuits samples, significant increase (P<0.05) in antioxidant activity, total phenolic content, and total flavonoid content was observed. These trends were observed to be more prominent with higher quantities of RCPF and GCPF. Notably, the antioxidant properties of chickpeas were found to be significantly improved (P<0.05) by the process of germination compared to roasting. Moreover, improvements in antioxidant activity might be caused by the increased levels of phenolic compounds and ascorbic acid due to the actions of endogenous hydrolytic enzymes during germination. The dimensional, textural, and sensory properties indicated that RCPF 20% and GCPF 10% can effectively serve as an organic fat substitute in bakery products with enhanced concentrations of proteins, fibers, antioxidants, and bioactive compounds with nutraceutical properties