Antibiotic Susceptibility and Plasmid Profiles of Shigella species in Sudan.

This study was carried out to determine the antibiotic susceptibility, plasmid profile and conjugative abilities of Shigella species isolated from different towns in Sudan during 2005-2007.Methods: Stool specimens were collected in Carry Blair transport medium from patients presenting with diarrhea from different sites in Sudan between the years 2005-2007. All specimens were inoculated on Mac Conkey’s agar and Xylose Lysine Dioxycholate (XLD) (Mast group Ltd.Merseyside U.K.). Bacteria was isolated and subjected to different antibiotics to detect sensitivity and transference of resistance.Results: One hundred and fourteen Shigella isolates were included in the study. Eighty (70.1%) were Shigella flexeneri representing the dominant isolate, followed by 20 (17.5%) isolates of Shigella dysenteriae, 9 (7.9%) Shigella sonnei and 5 (4.5%) Shigella boydii. Most of the isolates showed resistance to streptomycin (70%), tetracycline (52%) and co-trimoxazole (43%). They were highly sensitive to norfloxacin (97%), nalidixic acid (95%), gentamicin (89%) and chloramphenicol (77%). Multi-drug resistance to two or more antibiotics was apparent in most of the isolates (64, 56.1%). Fifty nine of the resistant Shigella isolates were studied for their ability to transfer resistance to the donor E. coli K12 by conjugation. Of these, six were able to transfer resistance to streptomycin, tetracycline and co-trimoxazole. Extraction of the plasmid DNA from both donorsand trans-conjugants showed a single type of plasmid with a molecular weight of 4.6 Kb. Conclusion: The transfer of multi-drug resistant plasmids and the emergence of antibiotic Shigella and other bacterial species should raise the awareness and the seriousness of the uncontrolled (unsupervised)use of antibiotics in the medical practice.Key words: Shigella E. coli, Plasmid, conjugant, resistance transfer

Faecal Contamination of Feeding Bottles Contents, Among Artificially Fed Children

This study was carried out to investigate the bacterial contamination of feeding bottles contents in artificially fed children presenting with diarrhoea at the Paediatric outpatient clinic in Khartoum Hospital.Methods: Hundred bottle fed infants presenting with diarrhoea were included in the study. Specimens were collected from the contents of the feeding bottles and the faeces of children.Results: Hundred and ten bacterial species were isolated from the contents. E. coli was the commonest isolate [33 (30%)]. Different other bacterial species were also isolated with very high count (1X106 - > 15X105/ml). Twenty one enteric pathogens were isolated from the stool specimens [Enteropathogenic E. coli (7) and Shigella species (14)]. The antibiotic sensitivity of the E. coli and Shigella species showed high resistance to co-trimoxazole (57.5%, 53.3% respectively) and to coamoxiclav (85% - 53.3% respectively).Conclusion: Awareness to the hazards of the feeding bottles among the community should be raised and breast feeding should be encouraged.Key words: diarrhea, enteric pathogens, E. coli

Binding to CSA receptor is associated with asymptomatic and mild malaria: a preliminary study using P.falciparum field isolates from Sudan

Malaria imposes great socio-economic burden on humanity, and afflicts approximately 90 countries and territories in the tropical and subtropical regions, almost one half of them are in Africa, South of Sahara. Sequestration of parasitized erythrocytes within the small vessels of vital organs is a key event in the pathogenesis of malaria and responsible of virulence of Plasmodium falciparum parasite. To find out whether the ability of infected red blood cells (IRBCs) to adhere to a specific receptor is a risk factor for developing severe clinical manifestation of the disease, in-vitro cytoadhesion and inhibition experiments were performed on field isolates obtained from five symptomatic and five asymptomatic patients inhabiting Gazira State, Central Sudan. The results showed significant lower levels (

An Appraisal of the Maternal Mortality Decline in Nepal

Peer reviewedPublisher PD

Observed Reductions in Schistosoma mansoni Transmission from Large-Scale Administration of Praziquantel in Uganda: A Mathematical Modelling Study

To date schistosomiasis control programmes based on chemotherapy have largely aimed at controlling morbidity in treated individuals rather than at suppressing transmission. In this study, a mathematical modelling approach was used to estimate reductions in the rate of Schistosoma mansoni reinfection following annual mass drug administration (MDA) with praziquantel in Uganda over four years (2003-2006). In doing this we aim to elucidate the benefits of MDA in reducing community transmission.Age-structured models were fitted to a longitudinal cohort followed up across successive rounds of annual treatment for four years (Baseline: 2003, TREATMENT: 2004-2006; n = 1,764). Instead of modelling contamination, infection and immunity processes separately, these functions were combined in order to estimate a composite force of infection (FOI), i.e., the rate of parasite acquisition by hosts.MDA achieved substantial and statistically significant reductions in the FOI following one round of treatment in areas of low baseline infection intensity, and following two rounds in areas with high and medium intensities. In all areas, the FOI remained suppressed following a third round of treatment.This study represents one of the first attempts to monitor reductions in the FOI within a large-scale MDA schistosomiasis morbidity control programme in sub-Saharan Africa. The results indicate that the Schistosomiasis Control Initiative, as a model for other MDA programmes, is likely exerting a significant ancillary impact on reducing transmission within the community, and may provide health benefits to those who do not receive treatment. The results obtained will have implications for evaluating the cost-effectiveness of schistosomiasis control programmes and the design of monitoring and evaluation approaches in general

An unusual presentation of adenoid cystic carcinoma of the minor salivary glands with cranial nerve palsy: a case study

<p>Abstract</p> <p>Background</p> <p>Adenoid Cystic Carcinoma (ACC) is a rare tumor entity and comprises about 1% of all malignant tumor of the oral and maxillofacial region. It is slow growing but a highly invasive cancer with a high recurrence rate. Intracranial ACC is even more infrequent and could be primary or secondary occurring either by direct invasion, hematogenous spread, or perineural spread. We report the first case of the 5^thand 6^thnerve palsy due to cavernous sinus invasion by adenoid cystic carcinoma.</p> <p>Case presentation</p> <p>A 49-year-old African American female presented to the emergency room complaining of severe right-sided headache, photophobia, dizziness and nausea, with diplopia. The patient had a 14 year history migraine headaches, hypertension, and mild intermittent asthma. Physical examination revealed right lateral rectus muscle palsy with esotropia. There was numbness in all three divisions of the right trigeminal nerve. Motor and sensory examination of extremities was normal. An MRI of the brain/brain stem was obtained which showed a large mass in the clivus extending to involve the nasopharynx, pterygoid plate, sphenoid and right cavernous sinuses.</p> <p>Biopsy showed an ACC tumor with a cribriform pattern of the minor salivary glands. The patient underwent total gross surgical resection and radiation therapy.</p> <p>Conclusion</p> <p>This is a case of ACC of the minor salivary glands with intracranial invasion. The patient had long history of headaches which changed in character during the past year, and symptoms of acute 5^thand 6^thcranial nerve involvement. Our unique case demonstrates direct invasion of cavernous sinus and could explain the 5^thand 6^thcranial nerve involvement as histopathology revealed no perineural invasion.</p

Diversifying search in bee algorithms for numerical optimisation

© Springer Nature Switzerland AG 2018. Swarm intelligence offers useful instruments for developing collective behaviours to solve complex, ill-structured and large-scale problems. Efficiency in collective behaviours depends on how to harmonise the individual contributions so that a complementary collective effort can be achieved to offer a useful solution. The harmonisation helps blend diversification and intensification suitably towards efficient collective behaviours. In this study, two renown honeybees-inspired algorithms were analysed with respect to the balance of diversification and intensification and a hybrid algorithm is proposed to improve the efficiency accordingly. The proposed hybrid algorithm was tested with solving well-known highly dimensional numerical optimisation (benchmark) problems. Consequently, the proposed hybrid algorithm has demonstrated outperforming the two original bee algorithms in solving hard numerical optimisation benchmarks

Immunostimulation and Immunoinhibition of Premalignant Lesions

BACKGROUND: The immune reaction may be either stimulatory or inhibitory to tumor growth, depending upon the local ratio of immune reactants to tumor cells. HYPOTHESIS: A tumor-stimulatory immune response may be essential for survival of a neoplasm in vivo and for the biological progression from a premalignant lesion to a malignancy. Neither a positive nor a negative correlation between the magnitude of an immune-cell infiltrate and a cancer's prognosis can reveal whether the infiltrate was stimulating or inhibiting to the tumor's growth unless the position on the nonlinear curve that relates tumor growth to the magnitude of the immune reaction is known. DISCUSSION: This hypothesis is discussed in relation to the development of human malignant melanomas and colorectal cancers

Modulation of the immune response by nematode secreted acetylcholinesterase revealed by heterologous expression in Trypanosoma musculi

Nematode parasites secrete molecules which regulate the mammalian immune system, but their genetic intractability is a major impediment to identifying and characterising the biological effects of these molecules. We describe here a novel system for heterologous expression of helminth secreted proteins in the natural parasite of mice, Trypanosoma musculi, which can be used to analyse putative immunomodulatory functions. Trypanosomes were engineered to express a secreted acetylcholinesterase from Nippostrongylus brasiliensis. Infection of mice with transgenic parasites expressing acetylcholinesterase resulted in truncated infection, with trypanosomes cleared early from the circulation. Analysis of cellular phenotypes indicated that exposure to acetylcholinesterase in vivo promoted classical activation of macrophages (M1), with elevated production of nitric oxide and lowered arginase activity. This most likely occurred due to the altered cytokine environment, as splenocytes from mice infected with T. musculi expressing acetylcholinesterase showed enhanced production of IFNγ and TNFα, with diminished IL-4, IL-13 and IL-5. These results suggest that one of the functions of nematode secreted acetylcholinesterase may be to alter the cytokine environment in order to inhibit development of M2 macrophages which are deleterious to parasite survival. Transgenic T. musculi represents a valuable new vehicle to screen for novel immunoregulatory proteins by extracellular delivery in vivo to the murine host

Staff perspectives of barriers to women accessing birthing services in Nepal: A qualitative study

Background: Nepal has made significant progress with regard to reducing the maternal mortality ratio but a major challenge remains the under-utilisation of skilled birth attendants who are predominantly facility based. Studies have explored women's views of the barriers to facility birth; however the voices of staff who offer services have not been studied in detail. This research explores the views of staff as to the key reasons why pregnant women do not give birth in a maternity-care facility. Methods: This mixed methods study comprised qualitative interviews and non-participant observation. The study was conducted in two small non-governmental hospitals, one semi-rural and one urban, in Kathmandu Valley. Twenty interviews were conducted with health care providers and other staff in these hospitals. The interviews were undertaken with the aid of a Nepali translator, with some interviews being held in English. Twenty-five hours of non-participant observation was conducted in both maternity hospitals . Both observation and interview data were analysed thematically. Ethical approval was granted by the Nepal Research Health Council and Bournemouth University's Ethics Committee. Results: Key themes that emerged from the analysis reflected barriers that women experience in accessing services at different conceptual levels and resembled the three phases of delay model by Thaddeus and Maine. This framework is used to present the barriers. First Phase Delays are: 1) lack of awareness that the facility/services exist; 2) women being too busy to attend; 3) poor services; 4) embarrassment; and 5) financial issues. Themes for the second Phase of Delay are: 1) birthing on the way; and 2) by-passing the facility in favour of one further away. The final Phase involved: 1) absence of an enabling environment; and 2) disrespectful care. Conclusion: This study highlights a multitude of barriers, not all of the same importance or occuring at the same time in the pregnancy journey. It is clear that staff are aware of many of the barriers for women in reaching the facility to give birth, and these fit with previous literature of women's views. However, staff had limited insight into barriers occuring within the facility itself and were more likely to suggest that this was a problem for other institutions and not theirs