Mise au point et évaluation d'une technique de PCR permettant la détection et le typage des entérovirus directement à partir de produits pathologiques ou d'échantillons environnementaux

Human enteroviruses (EV), members of the Picornaviridae family, comprise more than 100 genotypes belonging to four species: Enterovirus A, B, C and D. These viruses are responsible for a wide range of pathologies and play an important role in Public Health. The classic method for typing EVs consists in a seroneutralisation assay with specific antisera using strains isolated by cell culture; this technique is cumbersome, expensive and unable to type currently antigenic variants and new serotypes. In addition, it is limitated to culturable serotypes. New methods of molecular typing by partial sequencing of the genome have been recently developed; they consist in analysing a variable part of the region coding for capsid protein (VP1 or alternatively VP2 or VP4). However, these techniques are usually performed on strains isolated by cell culture. The aim of this work was to develop a typing method able to work from clinical specimens by partial sequencing of the VP2 region, which had been shown to exhibit a good typing performance (Nasri et al., 2007). For the design of primers, we used the CODEHOP (COnsensus DEgenerate Hybrid Oligonucleotide Primer) strategy on order to improve the sensitivity and the specificity of the amplification assay. We present herein a first article that describes in details the new VP2 typing method and requests its use for typing clinical specimens found positive by a PCR assay targeting the 5’ non coding region of EVs over a period of three years. The second paper describes for the first time the direct use of a typing method on environtmental wastewater samples. The third article shows the interest of coupling 2 typing techniques targeting different regions (VP1 and VP2) of the EV genome for the identification of strains isolated by cell culture in Republic of Central Africa. Despite a loss of sensitivity, the new VP2 typing method used directly on specimens was found to be of great help both for human diagnosis and environmental surveillanceLes entérovirus (EV) humains, membres de la famille des Picornaviridae, comprennent plus de 100 génotypes appartenant à 4 espèces : Enterovirus A, B, C et D. Ces virus sont à l’origine de pathologies très variées et occupent une place importante en santé publique. La méthode conventionnelle de typage des EV consiste en une réaction de séroneutralisation avec des antisérums spécifiques à partir de souches isolées en culture cellulaire ; cette technique est longue, coûteuse et limitée par sa capacité à identifier correctement les variants antigéniques et les nouveaux génotypes. De plus, elle est limitée aux génotypes cultivables. De nouvelles méthodologies de typage moléculaire par séquençage partiel du génome ont été récemment développées ; elles consistent à analyser une partie variable de la région codant une des protéines de capside (VP1 ou alternativement VP2 ou VP4). Cependant ces techniques sont le plus souvent réalisées à partir de souches isolées en culture cellulaire. Le but de ce travail a été de développer une technique de typage des EV directement sur des prélèvements cliniques en se basant sur le séquençage partiel de la région VP2 dont le laboratoire avait montré précédemment l’intérêt (Nasri et al., 2007). Pour le dessin des amorces, nous avons utilisé la stratégie CODEHOP (COnsensus DEgenerate Hybrid Oligonucleotide Primer) de manière à améliorer à la fois la spécificité et la sensibilité de la méthode d’amplification. Nous présentons ici un premier article décrivant la nouvelle technique de typage VP2 et rapportons son application au typage d’échantillons cliniques trouvés positifs par une PCR ciblant la région 5’ non codante du génome des EV sur une période de trois ans. Le deuxième article présente pour la première fois l’application d’une technique de typage direct à des échantillons environnementaux d’eaux usées. Le troisième article montre l’intérêt de coupler deux techniques de typage ciblant des régions différentes (VP1 et VP2) pour l’identification de souches d’EV isolées par culture cellulaire en Centre-Afrique. Malgré des problèmes de sensibilité, cette nouvelle technique de typage directement à partir d’échantillons peut rendre de grands services tant en clinique humaine que pour la surveillance environnemental

Telemedicine in the Kingdom of Saudi Arabia: The feasibility of delivering parent-mediated early intervention targeting social communication in autism.

Background: Evidence on the effectiveness of telemedicine in coaching parents of autistic children on naturalistic developmental early interventions (EI) is limited and conducted in Western countries. In the Saudi context, little is known about EI services and the feasibility of telemedicine in coaching parents. Aims: 1) Examine the literature on the effectiveness of telemedicine in coaching parents to implement naturalistic developmental EI on child's social communication; 2) Investigate parents' and speech and language therapists' (SLTs) perceptions of EI and describe community-based practice with the aim of enhancing it, and 3) Investigate the feasibility of telemedicine to deliver community-based practice in coaching parents. Methods: A rapid review evaluated intervention characteristics, outcomes, and research quality in nine studies. Action research employed semi-structured interviews with six parents' and four SLTs' investigated the second aim. A sample of 47 parents completed the survey investigating telemedicine acceptability and intention to use. Finally, eleven parent-child dyads participated in a pre-post feasibility study investigating telemedicine's implementation, usability, and acceptability. Results: Review findings suggest insufficient evidence for the effectiveness of telemedicine on child's social communication. Action research showed that SLTs' EI practice was one-toone, therapist-implemented or hybrid, with no consistent parent training. SLTs' reported engaging parents in EI was challenging. Findings showed parents have mixed views about the service. Parents reported raising autistic children was effortful, and parents wanted more support. The surveys revealed high telemedicine acceptability, usability, and intention to use. In the feasibility study, parents showed low-moderate fidelity scores for full achievement and scored moderate-high for partial achievement of strategies. No significant treatment difference was observed in children's social communication. Conclusions: More high-quality research is required to examine the effectiveness of telemedicine applications on child's social communication in community-based settings to support access and continuity of therapy in EI services

Assessment Relationship Between Uric Acid and Ferritin in End-Stage Renal Disease Patients Undergoing Hemodialysis

مقدمة: اظهرت بعض الدراسات الطبية ان حمض اليوريك يخفض حديد الفريتين الي صيغة الحديدوز (حديد ثنائي التكافؤ) مباشرة, حيث يعمل الفريتين في هذه الحالة كمستقبل للالكترون. الاهداف: كان الهدف من هذه الدراسة للتحقيق في العلاقة بين حمض اليوريك والفريتين في مرضي الفشل الكلوي (في المرحلة الاخيرة منه) الذين يخضعون لغسيل الكلي. الطرق: شارك في هذه دراسة الاستعادية المقطعية حوالي ثلاث وخمسون شخصا من مرضي الفشل الكلوي (في المرحلة الاخيرة منه) الذين يخضعون لغسيل الكلي (متوسط اعمارهم 46.62 ± 15.6 ). تم جمع البيانات باستخدام الاستبيان والفحوص المعملية في الفترة ما بين يانير 2013 الي سبتمبر2017. النتائج: اظهر تحليل البيانات ارتفاع مستويات حمض اليوريك في بلازما مرضي الفشل الكلوي (المرحلة الاخيرة منه) والخاضعين لغسيل الكلي. واظهرت نتائجنا عدم وجود علاقة يعتد بها احصائيا بين حمض اليوريك والفريتين في هؤلاء المرضي. وايضا نفت نتائجنا وجود علاقة يعتد بها احصائيا بين حمض اليوريك وكل من مستوي الحديد في الدم , مقدرة الدم علي حمل الحديد , كمية تشبع الترانسفيرين بالحديد مستوي نيتروجين البولينا في الدم والكرياتنين. الخلاصة: اثبتت نتائجنا ارتفاع عالي في مستوى حمض اليوريك لدي مرضي الفشل الكلوي (المرحلة الاخيرة منه) والذين يخضعون لغسيل كلى .هذه الدراسة خلصت الي عدم وجود علاقة بين حمض اليوريك والفريتين في هؤلاء المرضى

Detection of Extended-Spectrum β-lactamases' (ESBLs) Resistance among Wound Infection Pathogens in Khartoum State

Abstract The presence of extended-spectrum-β lactamases (ESBLs) in a clinical infection can result in treatment failure if one of the third-generation cephalosporins is used. ESBLs detection has both clinical as well as epidemiological relevance. The present study was conducted to detect the frequency of ESBL producing pathogens that causes wound infections. Hundred wound samples were collected from Khartoum state Hospitals were investigated for isolation and identification (colonial characteristics, Gram reaction, biochemical reactions, and antibiotic susceptibility). The frequency of isolates from all cases was 95 (95%) with 5 (5%) yielding no growth. The isolates were E.coli, Klebsiella species, staph aureus, Proteus species and Pseudomonas aeruginosa which isolated from 27(28.4%), 13(13.68%), 23(24.21%), 20(21.05%) and 12(12.63%) respectively. The isolates were subjected to show their susceptibility against the third generation cephalosporins (Cefotaxime, Ceftazidime and Ceftriaxone) using disk diffusion method. The results were observed that 60(63.1%) out of 95 isolates shown resistance to third generation cephalosporins, while35 isolates were sensitive to these antibiotics. The sixty resistant isolates were subjected to show their ability to produce ESBL using Kirby _Bauer Method (Calvulanic acid + Third generation cephalosporins). Among 18 E.coli, 4 Klebsiella species, 16 Staph aureus, 12 Proteus species, 10 Pseudomonas aeruginosa, isolates which were tested, 6(33.33%), 1(25%), 9(56.2%), 3(30%) and 3(30%) were found to be ESBL producer respectively. We conclude that the ESBL producers were found in large proportions which may refers to misusing of antibiotics or inadequate treatment

Serofrequency of Cytomegalovirus among pregnant ladies attending antenatal care at Omdurman Maternity Hospital, Sudan

Abstract Background: Cytomegalovirus (CMV) is a member of the family herpesviridae .This study was conducted to determine the serofrequency of cytomegalovirus (CMV) among pregnant ladies at Omdurman Maternity Hospital between the period April to July 2014. Vertically transmitted Cytomegalovirus is the most common cause of preventable congenital infection. Till date, there is no consensus on routine antenatal screening worldwide

The Socio-Demographic Characteristics Associated with Non-Communicable Diseases among the Adult Population of Dubai: Results from Dubai Household Survey 2019.

BACKGROUND: Non-communicable diseases (NCDs) are the leading causes of death worldwide. In the UAE, NCDs account for nearly 77% of all deaths. There is limited empirical research on this topic in the UAE. We aimed to examine the association of non-communicable diseases and the sociodemographic characteristics among the adult population of Dubai. METHODS: The study used secondary data from the Dubai Household Health Survey (DHHS), 2019. DHHS is a cross-sectional complex design, stratified by geographic area, and uses multistage probability sampling. In this survey, 2247 families were interviewed and only adults aged 18+ were included for the analysis. The quasi-binomial distribution was used to identify the socio-demographic characteristics association with NCDs. RESULTS: The prevalence of NCDs among the adult population of Dubai was 15.01%. Individuals aged 60+, local Arabs (Emirati), divorced and widowed individuals, and individuals who were not currently working reported NCDs more than the other groups. In the regression analysis, the association with NCDs were reported among elderly people, males, unmarried individuals, older individuals who are unmarried, and Emiratis. CONCLUSION: The study identified several socio-demographic characteristics associated with reporting NCDs. This is one of the few studies related to NCDs in Dubai. Allocating appropriate resources to the population groups identified is crucial to reduce the incidence of NCDs in the Emirate

Teaching pharmacovigilance to undergraduate students: Our experience in poor-resource setting

Using medicines associated with adverse drug reactions (ADRs) might cause serious health complications. The pharmacist plays a unique role in monitoring ADRs, either by themselves or with the assistance of other health-care professionals, to diminish the hazards of ADRs by distinguishing, reporting, and evaluating any proposed ADRs. To train future pharmacists who have adequate knowledge of ADRs and related aspects, it is highly recommended to introduce the WHO-ISoP pharmacovigilance (PV) in the core curriculum. In this article, we shared the suggested curriculum in Aden University. It is based on comprehensive outlines and reference books that offer a broad view of all aspects related to PV. A brief student course evaluation was carried out. Fifty students participated in the survey. Students expressed the importance of the course and indicated that they wanted to know more about the types of ADRs and common medication errors. Some of them lacked an understanding of the causal relationship between ADRs and risk assessment and not familiar with the reporting forms. They suggested for PV awareness programs for health-care staff and public. The curriculum should be tailored according to the country's needs because each country has its own medication safety issues and PV program. To reach the ultimate objective, this article reports the initiative to develop PV proficiencies in a university setting

Seroprevalence of Cytomegalovirus among Blood Donors at Omdurman Teaching Hospital, Omdurman, Sudan

Abstract: Backgroun

Innovative Approaches To Nursing Administration Education; A Systematic Review Based Study

Background: Nursing administration education plays a crucial role in the development of skilled leaders in the ever-evolving healthcare industry. To meet the current challenges in healthcare, it is crucial to employ innovative pedagogical approaches. These approaches include the integration of virtual reality simulations, fostering interdisciplinary collaboration, utilizing real-world case studies, implementing telehealth platforms, and establishing mentorship programs. Addressing this need for forward-thinking nursing administrators is imperative. Aim: This study comprehensively examines the impact of these innovative strategies on nursing administration education. It assesses how their integration enhances decision-making, communication, strategic thinking, technological proficiency, and leadership skills among students. The goal is to illuminate the potential of these approaches in molding skilled healthcare leaders. Method: A mixed-methods approach is utilized. Qualitative interviews with nursing administration students exposed to innovative approaches provide insights. Thematic analysis is employed to extract meaningful patterns, capturing both subjective experiences and skill development outcomes. Results: Findings highlight the transformative potential of innovative approaches in nursing administration education. Virtual reality simulations enhance decision-making, interdisciplinary collaboration fosters effective communication and teamwork, real-world case studies cultivate strategic thinking, telehealth platforms enhance remote service proficiency, and mentorship programs empower leadership competencies. Conclusion: This study underscores the pivotal role of innovation in shaping adept nursing administrators. Integration of innovative approaches equips healthcare leaders with holistic perspectives, adaptable skills, and technological readiness. As healthcare systems evolve, these approaches offer promise for addressing challenges effectively. Innovative Contribution: By delving into cutting-edge nursing administration education, this study offers insights that reshape healthcare leadership. It bridges theory and practice, equipping future administrators to navigate the dynamic healthcare landscape