The Mysterious, Threat We Will Confront Mycobacterium Chelonae

Background: Surgical wound infection is an internationally recognized complication which is expected to get cured in few days time. Lack of antibiotic policies added to the existing chaos in free market policies is expected to end up with mysterious resistant organisms soon in future. Objectives: To report our experience with 52 key hole protracted surgical wound infections in 23 patients. Patients and methods: Demographic data of patients who suffered post operative subcutaneous wound nodules following minimal access surgery, duration of the disease and its clinical manifestations as well as results of investigations were collected and analysed. Results: Two males and 21 females, age range 27-65 (median 42) years had 32 key-hole wound nodules and 20 persistent discharging wounds that had appeared in an average but latent period of nine weeks (range three weeks to sixmonths after surgery). Only two cultures were positive for Mycobacterium chelonae. Conclusion: Mycobacterium chelonae should be suspected in protracted surgical wounds and treated promptly with meticulous frequent dressings, wound excision and clarithromycin plus ceftazidime. Keywords: surgical wounds, subcutaneous, mycobacterium, catalase, resistant organisms.Sudan Journal of Medical Sciences Vol. 3 (2) 2008: pp. 133-13

Therapeutic role of glucogalactan polysaccharide extracted from Agaricus bisporus on trimethyltin chloride induced neuropathy in rats

Trimethyltin (TMT) chloride induces limbic system neuro-degeneration, resulting in behavioral alterations like cognitive deficits. This study investigates the effect of glucogalactan polysaccharide (GA) extract, which was purified from the roots of Agaricus bisporus mushroom, on trimethyltin chloride (TMT) induced neuropathy in rats. Adult male rats (200 ±10 g) were divided into four groups that were fed with basal diet throughout the experiment (28 days). The first group (G I) was control group, the second group (GII) was treated with 300 mg/kg BW GA intraperitoneally (i.p.) daily for 28 day. The third group (GIII) was administered i.p. with 8.0 mg TMT /kg body weight (BW), and the fourth (G IV) was treated like the third group and was injected with GA 300 mg/kg BW daily for 28 day after 48 h of TMT. Many bioactive compounds, which were found in GA did not cause any changes in the second group compared to normal control group. The results reveal that GA given 48 h after TMT treatment has excellent neuropathy effect, lowers the average of MDA, HSP70, homocystein and the neurotransmitters in brain tissue homogenate; they were markedly reduced by the administration of GA to almost normal levels. Neurotransmitters and nitric oxide were significantly increased in the group given GA treatment compared to TMT group. The comet assay for DNA revealed that, TMT induced statistically significant (P<0.05) increase in the mean value of the tail length and tail moment of the rats. They significantly decreased after GA treatment, suggesting alleviated oxidative stress mediated by TMT. GA administered TMT-treated rats had improved brain histology, diminished level of MDA and nitric oxide (NO) in brain tissue and enhanced total antioxidant capacity in serum compared to TMT group. It could be concluded that GA plays a positive role in the improvement of brain function after TMT-induced neuropathy. Taken together, our results suggest that GA will be useful in developing strategies for protecting nervous system and improving the brain.Keywords: Trimethyltin, neuro-degeneration, Agaricusbisporus, glucogalactan

Staff Knowledge, Adherence to Infection Control Recommendations and Seroconversion Rates in Hemodialysis Centers in Khartoum

Introduction: We evaluated hemodialysis (HD) staff knowledge, adherence to infection control recommendations and seroconversion rates for hepatitis B virus (HBV) and hepatitis C virus (HCV) in 13 centers that continuously provided HD services in Khartoum State between June 2009 and November 2010. Methods: The knowledge of 182 HD staff members was evaluated by a self-filled questionnaire. Relevant data were obtained from 1011 HD patients by direct interviews and record review. Adherence of staff members to infection control recommendations was evaluated by direct observation. Results: HD staff members achieved a median score of 81% in knowledge evaluation (range 44-100%). Better scores were achieved by more experienced staff. We identified serious gaps in knowledge related to the environmental risk of viral transmission. Regular screening by enzyme-linked immunoassay (ELISA) was performed in 46% of centers. Only half susceptible patients were vaccinated against HBV. Staff dedicated for treatment of HBV positive patients were found in only 57% of centers that served such patients. Hand washing recommendations were strictly observed in 15% of centers, disinfection of HD stations between patients was strictly observed in 23% of centers, medications were prepared in a separate area in 8% of centers and delivered separately to each patient in none of the centers. There were 2.5 HCV seroconversions and 0.6 HBV seroconversions per 100 patient-years. Center characteristics that predicted HCV seroconversion were accommodation of HCV-positive patients in the same center, using ELISA for patient screening, and assigning more than 3 patients for one HD nurse. Conclusion: There are serious gaps in HD staff knowledge and adherence to infection control recommendations. A structured training program for HD staff members is urgently required. Keywords: Hemodialysis; HBV; HCV; Infection Control; Khartou

Insecticidal Activity of Lemongrass Essential Oil as an Eco-Friendly Agent against the Black Cutworm Agrotis ipsilon (Lepidoptera: Noctuidae)

This is the final version. Available on open access from MDPI via the DOI in this recordBackground: The destructive insect pest Agrotis ipsilon (Hufnagel) (Lepidoptera: Noctuidae) is a polyphagous species targeting many economically important plants. The extensive and arbitrary use of insecticides has resulted in the build-up of insecticide resistance and pesticide residues accumulating in food. Therefore, it is becoming evident that alternative pest management tools are needed to reduce risks to humans, the environment, and non-target organisms, and at the same time, they should be used in field application at the lowest cost. Methods: In view of this objective, the present study demonstrates the toxicity of lemongrass (Cymbopogon citratus (DC.) Stapf) essential oil (EO), against the black cutworm A. ipsilon under controlled laboratory conditions in terms of measuring the activity of peroxidase and detoxification enzymes. The chemical components of the EO were analyzed using GC–MS. Results: The results show that after 96 h post treatment, the LC15 and LC50 values were 427.67 and 2623.06 mg/L, respectively, of C. citratus EO on second-instar larvae of A. ipsilon. A slight significance in elongation of the larval duration with LC15 and LC50 value was found with control. By GC–MS analysis, the main compounds identified in the EO were α-citral and β-citral with percentages of 35.91%, and 35%, respectively. The oxidative stress indicates a significant increase in CAT and lipid peroxidase enzyme activity after 96 h post treatment at the LC15 and LC50. Conversely, the detoxification enzyme activity shows an inhibition of CarE and GST enzymes of larvae exposed to LC15 and LC50 values in response to C. citratus EO. Conclusions: The present data show that lemongrass EO has insecticidal activity against the black cutworm, A. ipsilon.King Saud University, Riyadh, Saudi Arabi

State-of-the-Art of Establishing Test Procedures for Real Driving Gaseous Emissions from Light- and Heavy-Duty Vehicles

Air pollution caused by vehicle emissions has raised serious public health concerns. Vehicle emissions generally depend on many factors, such as the nature of the vehicle, driving style, traffic conditions, emission control technologies, and operational conditions. Concerns about the certification cycles used by various regulatory authorities are growing due to the difference in emission during certification procedure and Real Driving Emissions (RDE). Under laboratory conditions, certification tests are performed in a ‘chassis dynamometer’ for light-duty vehicles (LDVs) and an ‘engine dynamometer’ for heavy-duty vehicles (HDVs). As a result, the test drive cycles used to measure the automotive emissions do not correctly reflect the vehicle’s real-world driving pattern. Consequently, the RDE regulation is being phased in to reduce the disparity between type approval and vehicle’s real-world emissions. According to this review, different variables such as traffic signals, driving dynamics, congestions, altitude, ambient temperature, and so on have a major influence on actual driving pollution. Aside from that, cold-start and hot-start have been shown to have an effect on on-road pollution. Contrary to common opinion, new technology such as start-stop systems boost automotive emissions rather than decreasing them owing to unfavourable conditions from the point of view of exhaust emissions and exhaust after-treatment systems. In addition, the driving dynamics are not represented in the current laboratory-based test procedures. As a result, it is critical to establish an on-road testing protocol to obtain a true representation of vehicular emissions and reduce emissions to a standard level. The incorporation of RDE clauses into certification procedures would have a positive impact on global air quality

Development of a blood-based molecular biomarker test for identification of schizophrenia before disease onset

Recent research efforts have progressively shifted towards preventative psychiatry and prognostic identification of individuals before disease onset. We describe the development of a serum biomarker test for the identification of individuals at risk of developing schizophrenia based on multiplex immunoassay profiling analysis of 957 serum samples. First, we conducted a meta-analysis of five independent cohorts of 127 first-onset drug-naive schizophrenia patients and 204 controls. Using least absolute shrinkage and selection operator regression, we identified an optimal panel of 26 biomarkers that best discriminated patients and controls. Next, we successfully validated this biomarker panel using two independent validation cohorts of 93 patients and 88 controls, which yielded an area under the curve (AUC) of 0.97 (0.95-1.00) for schizophrenia detection. Finally, we tested its predictive performance for identifying patients before onset of psychosis using two cohorts of 445 pre-onset or at-risk individuals. The predictive performance achieved by the panel was excellent for identifying USA military personnel (AUC: 0.90 (0.86-0.95)) and help-seeking prodromal individuals (AUC: 0.82 (0.71-0.93)) who developed schizophrenia up to 2 years after baseline sampling. The performance increased further using the latter cohort following the incorporation of CAARMS (Comprehensive Assessment of At-Risk Mental State) positive subscale symptom scores into the model (AUC: 0.90 (0.82-0.98)). The current findings may represent the first successful step towards a test that could address the clinical need for early intervention in psychiatry. Further developments of a combined molecular/symptom-based test will aid clinicians in the identification of vulnerable patients early in the disease process, allowing more effective therapeutic intervention before overt disease onset

Swedish high school students' knowledge and attitudes regarding fertility and family building

<p>Abstract</p> <p>Background</p> <p>Infertility is a serious problem for those who suffer. Some of the risks for infertility are preventable and the individual should therefore have knowledge of them. The purposes of this study were to investigate high-school students' knowledge about fertility, plans for family building and to compare views and knowledge between female and male students.</p> <p>Methods</p> <p>A questionnaire containing 34 items was answered by 274 students. Answers from male and female students were compared using student's <it>t</it>-test for normally distributed variables and Mann-Whitney <it>U</it>-test for non-normal distributions. The chi-square test was used to compare proportions of male and female students who answered questions on nominal and ordinal scales. Differences were considered as statistically significant at a <it>p</it>-value of 0.05.</p> <p>Results</p> <p>Analyses showed that 234 (85%) intended to have children. Female students felt parenthood to be significantly more important than male students: <it>p </it>= <it><</it>0.01. The mean age at which the respondents thought they would like to start to build their family was 26 (± 2.9) years. Men believed that women's fertility declined significantly later than women did: <it>p </it>= <it><</it>0.01. Women answered that 30.7% couples were involuntarily infertile and men answered 22.5%: <it>p </it>= <it><</it>0.01. Females thought it significantly more likely that they would consider IVF or adoption than men, <it>p = </it>0.01. Men felt they were more likely to abstain from having children than women: <it>p = <</it>0.01. Women believed that body weight influenced fertility significantly more often than men: <it>p = <</it>0.01 and men believed significantly more often that smoking influenced fertility: <it>p </it>= 0.03. Both female and male students answered that they would like to have more knowledge about the area of fertility.</p> <p>Conclusions</p> <p>Young people plan to start their families when the woman's fertility is already in decline. Improving young people's knowledge about these issues would give them more opportunity to take responsibility for their sexual health and to take an active role in shaping political change to improve conditions for earlier parenthood.</p

Preconception Care and Treatment with Assisted Reproductive Technologies

Couples with fertility problems seeking treatment with assisted reproductive technologies (ART) such as in vitro fertilization should receive preconception counseling on all factors that are provided when counseling patients without fertility problems. Additional counseling should address success rates and possible risks from ART therapies. Success rates from ART are improving, with the highest live birth rates averaging about 40% per cycle among women less than 35 years old. A woman’s age lowers the chance of achieving a live birth, as do smoking, obesity, and infertility diagnoses such as hydrosalpinx, uterine leiomyoma, or male factor infertility. Singletons conceived with ART may have lower birth weights. Animal studies suggest that genetic imprinting disorders may be induced by certain embryo culture conditions. The major risk from ovarian stimulation is multiple gestation. About one-third of live-birth deliveries from ART have more than one infant, and twins represent 85% of these multiple-birth children. There are more complications in multiple gestation pregnancies, infants are more likely to be born preterm and with other health problems, and families caring for multiples experience more stress. Transferring fewer embryos per cycle reduces the multiple birth rate from ART, but the patient may have to pay for additional cycles of ART because of a lower likelihood of pregnancy

Mapping of mosquito breeding sites in malaria endemic areas in Pos Lenjang, Kuala Lipis, Pahang, Malaysia

<p>Abstract</p> <p>Background</p> <p>The application of the Geographic Information Systems (GIS) to the study of vector transmitted diseases considerably improves the management of the information obtained from the field survey and facilitates the study of the distribution patterns of the vector species.</p> <p>Methods</p> <p>As part of a study to assess remote sensing data as a tool for vector mapping, geographical features like rivers, small streams, forest, roads and residential area were digitized from the satellite images and overlaid with entomological data. Map of larval breeding habitats distribution and map of malaria transmission risk area were developed using a combination of field data, satellite image analysis and GIS technique. All digital data in the GIS were displayed in the WGS 1984 coordinate system. Six occasions of larval surveillance were also conducted to determine the species of mosquitoes, their characteristics and the abundance of habitats.</p> <p>Results</p> <p>Larval survey studies showed that anopheline and culicine larvae were collected and mapped from 79 and 67 breeding sites respectively. Breeding habitats were located at 100-400 m from human settlement. Map of villages with 400 m buffer zone visualizes that more than 80% of <it>Anopheles maculatus s.s</it>. immature habitats were found within the buffer zone.</p> <p>Conclusions</p> <p>This study amplifies the need for a broadening of the GIS approach which is emphasized with the aim of rejuvenating the dynamic aspect of entomological studies in Malaysia. In fact, the use of such basic GIS platforms promote a more rational basis for strategic planning and management in the control of endemic diseases at the national level.</p

The dominant Anopheles vectors of human malaria in the Asia-Pacific region: occurrence data, distribution maps and bionomic précis

<p>Abstract</p> <p>Background</p> <p>The final article in a series of three publications examining the global distribution of 41 dominant vector species (DVS) of malaria is presented here. The first publication examined the DVS from the Americas, with the second covering those species present in Africa, Europe and the Middle East. Here we discuss the 19 DVS of the Asian-Pacific region. This region experiences a high diversity of vector species, many occurring sympatrically, which, combined with the occurrence of a high number of species complexes and suspected species complexes, and behavioural plasticity of many of these major vectors, adds a level of entomological complexity not comparable elsewhere globally. To try and untangle the intricacy of the vectors of this region and to increase the effectiveness of vector control interventions, an understanding of the contemporary distribution of each species, combined with a synthesis of the current knowledge of their behaviour and ecology is needed.</p> <p>Results</p> <p>Expert opinion (EO) range maps, created with the most up-to-date expert knowledge of each DVS distribution, were combined with a contemporary database of occurrence data and a suite of open access, environmental and climatic variables. Using the Boosted Regression Tree (BRT) modelling method, distribution maps of each DVS were produced. The occurrence data were abstracted from the formal, published literature, plus other relevant sources, resulting in the collation of DVS occurrence at 10116 locations across 31 countries, of which 8853 were successfully geo-referenced and 7430 were resolved to spatial areas that could be included in the BRT model. A detailed summary of the information on the bionomics of each species and species complex is also presented.</p> <p>Conclusions</p> <p>This article concludes a project aimed to establish the contemporary global distribution of the DVS of malaria. The three articles produced are intended as a detailed reference for scientists continuing research into the aspects of taxonomy, biology and ecology relevant to species-specific vector control. This research is particularly relevant to help unravel the complicated taxonomic status, ecology and epidemiology of the vectors of the Asia-Pacific region. All the occurrence data, predictive maps and EO-shape files generated during the production of these publications will be made available in the public domain. We hope that this will encourage data sharing to improve future iterations of the distribution maps.</p