Prevalence of Group A beta-haemolytic Streptococcus isolated from children with acute pharyngotonsillitis in Aden, Yemen.

OBJECTIVES: To estimate the prevalence of Group A beta-haemolytic streptococcus (GAS) and non-GAS infections among children with acute pharyngotonsillitis in Aden, Yemen, to evaluate the value of a rapid diagnostic test and the McIsaac score for patient management in this setting and to determine the occurrence of emm genotypes among a subset of GAS isolated from children with acute pharyngotonsillitis and a history of acute rheumatic fever (ARF) or rheumatic heart disease (RHD). METHODS: Group A beta-haemolytic streptococcus infections in school-aged children with acute pharyngotonsillitis in Aden, Yemen, were diagnosed by a rapid GAS antigen detection test (RADT) and/or GAS culture from a throat swab. The RADT value and the McIsaac screening score for patient management were evaluated. The emm genotype of a subset of GAS isolates was determined. RESULTS: Group A beta-haemolytic streptococcus pharyngotonsillitis was diagnosed in 287/691 (41.5%; 95% CI 37.8-45.3) children. Group B, Group C and Group G beta-haemolytic streptococci were isolated from 4.3% children. The RADT had a sensitivity of 238/258 (92.2%) and specificity of 404/423 (95.5%) against GAS culture. A McIsaac score of ≥4 had a sensitivity of 93% and a specificity of 82% for confirmed GAS infection. The emm genotypes in 21 GAS isolates from children with pharyngitis and a history of ARF and confirmed RHD were emm87 (11), emm12 (6), emm28 (3) and emm5 (1). CONCLUSION: This study demonstrates a very high prevalence of GAS infections in Yemeni children and the value of the RADT and the McIsaac score in this setting. More extensive emm genotyping is necessary to understand the local epidemiology of circulating strains

GaInNAs-based Hellish-vertical cavity semiconductor optical amplifier for 1.3 μm operation

Hot electron light emission and lasing in semiconductor heterostructure (Hellish) devices are surface emitters the operation of which is based on the longitudinal injection of electrons and holes in the active region. These devices can be designed to be used as vertical cavity surface emitting laser or, as in this study, as a vertical cavity semiconductor optical amplifier (VCSOA). This study investigates the prospects for a Hellish VCSOA based on GaInNAs/GaAs material for operation in the 1.3-μm wavelength range. Hellish VCSOAs have increased functionality, and use undoped distributed Bragg reflectors; and this coupled with direct injection into the active region is expected to yield improvements in the gain and bandwidth. The design of the Hellish VCSOA is based on the transfer matrix method and the optical field distribution within the structure, where the determination of the position of quantum wells is crucial. A full assessment of Hellish VCSOAs has been performed in a device with eleven layers of Ga0.35In0.65N0.02As0.08/GaAs quantum wells (QWs) in the active region. It was characterised through I-V, L-V and by spectral photoluminescence, electroluminescence and electro-photoluminescence as a function of temperature and applied bias. Cavity resonance and gain peak curves have been calculated at different temperatures. Good agreement between experimental and theoretical results has been obtained

Quantitative trait loci conferring grain mineral nutrient concentrations in durum wheat 3 wild emmer wheat RIL population

Mineral nutrient malnutrition, and particularly deficiency in zinc and iron, afflicts over 3 billion people worldwide. Wild emmer wheat, Triticum turgidum ssp. dicoccoides, genepool harbors a rich allelic repertoire for mineral nutrients in the grain. The genetic and physiological basis of grain protein, micronutrients (zinc, iron, copper and manganese) and macronutrients (calcium, magnesium, potassium, phosphorus and sulfur) concentration was studied in tetraploid wheat population of 152 recombinant inbred lines (RILs), derived from a cross between durum wheat (cv. Langdon) and wild emmer (accession G18-16). Wide genetic variation was found among the RILs for all grain minerals, with considerable transgressive effect. A total of 82 QTLs were mapped for 10 minerals with LOD score range of 3.2–16.7. Most QTLs were in favor of the wild allele (50 QTLs). Fourteen pairs of QTLs for the same trait were mapped to seemingly homoeologous positions, reflecting synteny between the A and B genomes. Significant positive correlation was found between grain protein concentration (GPC), Zn, Fe and Cu, which was supported by significant overlap between the respective QTLs, suggesting common physiological and/or genetic factors controlling the concentrations of these mineral nutrients. Few genomic regions (chromosomes 2A, 5A, 6B and 7A) were found to harbor clusters of QTLs for GPC and other nutrients. These identified QTLs may facilitate the use of wild alleles for improving grain nutritional quality of elite wheat cultivars, especially in terms of protein, Zn and Fe

Ophthalmic medicolegal cases in Upper Egypt

<p>Abstract</p> <p>Purpose</p> <p>To describe the pattern of ophthalmic medicolegal cases with emphasis on cases of assault, and to acquaint ophthalmologists with rules pertaining to expert testimony and medical reports.</p> <p>Methods</p> <p>A retrospective study was carried out to review files of 247 medicolegal cases from Upper Egypt seen by the senior author in 8 years. These were classified categorically and were analyzed from various characteristics and aspects. The scheme for examination of subjects and for formulating the medicolegal report is described.</p> <p>Results</p> <p>The different categories were assault in 224 cases (90.5%), military recruitment evasion in 8 cases (3.25%), occupational disability claims in 8 cases (3.25%) and medical malpractice in 7 cases (3%). Thirty two cases (13%) presented with alleged functional visual loss, of them 25 cases (10%) were malingering. Traumatic lens subluxation or dislocation was seen in 37 (13.5%) cases and phthisis and atrophia bulbi was the presenting sign in 55 (22.3%) cases. Twenty percent of assault cases were females. There were no differences in incidence between the provinces in Upper Egypt. Assault tools inflicted injuries are described, as well as the outcome of these cases. Claims against military recruits could not be substantiated. Occupational claims for damages were false. Alleged medical negligence cases were rejected based on accepted standards of care and not on unexpected complications.</p> <p>Conclusion</p> <p>Medical reports have to be structured, detailed, accurate and unbiased. Data in this work are useful for statistical and planning purposes in the medicolegal domain.</p

Evaluation Of The Essential Oil Of Foeniculum Vulgare Mill (Fennel) Fruits Extracted By Three Different Extraction Methods By Gc/Ms

Background: Hydrodistillation (HD) and steam-distillation, or solvent extraction methods of essential oils have some disadvantages like thermal decomposition of extracts, its contamination with solvent or solvent residues and the pollution of residual vegetal material with solvent which can be also an environmental problem. Thus, new green techniques, such as supercritical fluid extraction and microwave assisted techniques, are potential solutions to overcome these disadvantages.Materials and Methods: The aim of this study was to evaluate the essential oil of Foeniculum vulgare subsp. Piperitum fruits extracted by three different extraction methods viz. Supercritical fluid extraction (SFE) using CO2, microwave-assisted extraction (MAE) and hydro-distillation (HD) using gas chromatography-mass spectrometry (GC/MS).Results: The results revealed that both MAE and SFE enhanced the extraction efficiency of the interested components. MAE gave the highest yield of oil as well as higher percentage of Fenchone (28%), whereas SFE gave the highest percentage of anethol (72%).Conclusion: Microwave-assisted extraction (MAE) and supercritical fluid extraction (SFE) not only enhanced the essential oil extraction but also saved time, reduced the solvents use and produced, ecologically, green technologies.Keywords: Foeniculum vulgare subsp. Piperitum, microwave-assisted extraction (MAE), Supercritical fluid extraction (SFE), Essential Oils,Anethol, Fenchone, Limonene, Pinene, GC/MS

Influential factors on the levels of cation exchange capacity in sediment at Langat river.

An exploratory study was carried out at 22 sampling stations along the Langat River, Selangor in order to investigate on the vitality of cation exchange capacity (CEC) in sediment (0–5 cm). Parameters such as pH, Eh, salinity, and electrical conductivity (EC) were determined. The CEC in sediment has been calculated by the determination of Ca2+, Na+, Mg2+, and K+ using the flame atomic absorption spectrophotometer, while the organic matter content in sediment was ascertained using the loss on ignition method. The characteristic of the sediment shows that pH (3.09–7.46), salinity (0.02–10.71 ppt), EC (3.39–517 μS/cm) and Eh (−16.20–253.10 mV) were substantially high in variation. This study also revealed that exchangeable Ca2+ and Mg2+ were controlled by organic matter contents, while exchangeable Na+ and K+ were influenced by salinity. Salinity was observed to play a major part in controlling all the exchangeable cations, as it gives strong significant correlations with Na+, K+, Mg2+, CEC, and organic matter at p < 0.01. The presence of seawater, clay mineralogy, and organic matter proves that it does play an important role in determining the CEC and soon relates to the pollution magnitude in the sediment

A systematic review and meta-analysis to determine the contribution of mr imaging to the diagnosis of foetal brain abnormalities In Utero.

OBJECTIVES: This systematic review was undertaken to define the diagnostic performance of in utero MR (iuMR) imaging when attempting to confirm, exclude or provide additional information compared with the information provided by prenatal ultrasound scans (USS) when there is a suspicion of foetal brain abnormality. METHODS: Electronic databases were searched as well as relevant journals and conference proceedings. Reference lists of applicable studies were also explored. Data extraction was conducted by two reviewers independently to identify relevant studies for inclusion in the review. Inclusion criteria were original research that reported the findings of prenatal USS and iuMR imaging and findings in terms of accuracy as judged by an outcome reference diagnosis for foetal brain abnormalities. RESULTS: 34 studies met the inclusion criteria which allowed diagnostic accuracy to be calculated in 959 cases, all of which had an outcome reference diagnosis determined by postnatal imaging, surgery or autopsy. iuMR imaging gave the correct diagnosis in 91 % which was an increase of 16 % above that achieved by USS alone. CONCLUSION: iuMR imaging makes a significant contribution to the diagnosis of foetal brain abnormalities, increasing the diagnostic accuracy achievable by USS alone. KEY POINTS: • Ultrasound is the primary modality for monitoring foetal brain development during pregnancy • iuMRI used together with ultrasound is more accurate for detecting foetal brain abnormalities • iuMR imaging is most helpful for detecting midline brain abnormalities • The moderate heterogeneity of reviewed studies may compromise findings

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Prenatal Exposure to Wood Fuel Smoke and Low Birth Weight

Background: Maternal exposure to wood fuel smoke may lead to impaired fetal growth due to hypoxia and or oxidative stress from smoke constituents such as carbon monoxide and particulate matter. Objectives: We studied the risk of low birth weight (LBW) and reduced mean birth weight in relation to reported use of wood for cooking during the prenatal period, compared with natural gas (NG).Methods: We studied a historical cohort of women who had a singleton live birth in the years 2000-2002, from a semirural area of Pakistan. Infant\u27s birth weight was obtained from records, and prenatal records had data for maternal body mass index and parity. Cooking habits, daytime sleep habits, and type of fuel used during the pregnancies in 2000-2002 were ascertained by a survey done in 2004-2005. We performed multiple linear and logistic regression modeling using propensity scores to adjust for confounding variables.Results: Unadjusted mean (+/- SD) birth weight was 2.78 +/- 0.45 kg in wood users, and 2.84 +/- 0.43 kg (p \u3c 0.06) in NG users. Infants born to wood users averaged 82 g lighter than infants born to NG users when weight was adjusted for confounders (p \u3c 0.07). The rate of LBW (\u3c 2,500 g) was 22.7% among wood users compared with 15.0% in NG users (p \u3c 0.01), for an adjusted relative risk of 1.64 (95% confidence interval, 1.10-2-34). The population attributable risk for LBW explained by wood use was estimated to be 24%.Conclusion: Cooking with wood fuel during pregnancy, a potentially modifiable exposure, was associated with LBW and marginally lower mean birth weight compared with using NG