Helicobacter pylori infection might be responsible for the interconnection between type 1 diabetes and autoimmune thyroiditis

<p>Abstract</p> <p>Background</p> <p>Higher serological prevalence rates of helicobacter pylori (H. pylori) infection have been reported in patients with type 1 diabetes (T1DM) and autoimmune thyroiditis (AT). Patients with T1DM are at increased risk for developing other autoimmune diseases, most commonly AT. It is unknown whether H. pylori infection could explain the high prevalence of thyroid autoantibodies and AT in T1DM. The aim of the current study was to evaluate anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-Tg) autoantibodies in correlation with anti-H. pylori IgG and IgA in young patients with T1DM.</p> <p>Methods</p> <p>Anti-H. Pylori IgG, IgA, anti-TPO and anti-Tg antibodies titers were measured in 162 euthyroid patients with T1DM and 80 healthy controls matched for age, sex and socioeconomic status.</p> <p>Results</p> <p>Seroprevalence of H. pylori was significantly higher in patients with T1DM than in healthy controls; 79% vs. 51.2%, p < 0.001. Anti H. pylori IgG was positive in 61.1% of patients with T1DM and 30% of controls, p < 0.001, anti H. pylori IgA was positive in 74% of patients with T1DM and 32.5% of controls, p < 0.001. Thyroid autoimmunity was also significantly higher in patients with T1DM than in controls; 56.7% vs. 6.2%, p < 0.001. Anti-TPO was positive in 25.3% of patients with T1DM and 3.7% of controls, p < 0.001, anti-Tg was positive in 47.5% of patients with T1DM and 6.2% of controls, p < 0.001. With simple and multiple regression analysis anti-H. pylori IgG and IgA titers were positively and significantly correlated with Anti-TPO and anti-Tg titers in patients with T1DM.</p> <p>Conclusion</p> <p>our results support the idea of a connection between H. pylori infection and the occurrence of anti-TPO, anti-Tg autoantibodies and AT in young patients with T1DM. So, H. pylori infection could be considered as an environmental trigger for development of AT in T1DM. Young patients with T1DM should be screened for H. pylori infection.</p

Elevated serum neutrophil elastase is related to prehypertension and airflow limitation in obese women

<p>Abstract</p> <p>Background</p> <p>Neutrophil elastase level/activity is elevated in a variety of diseases such as atherosclerosis, systolic hypertension and obstructive pulmonary disease. It is unknown whether obese individuals with prehypertension also have elevated neutrophil elastase, and if so, whether it has a deleterious effect on pulmonary function. Objectives: To determine neutrophil elastase levels in obese prehypertensive women and investigate correlations with pulmonary function tests.</p> <p>Methods</p> <p>Thirty obese prehypertensive women were compared with 30 obese normotensive subjects and 30 healthy controls. The study groups were matched for age. Measurements: The following were determined: body mass index, waist circumference, blood pressure, lipid profile, high sensitivity C-reactive protein, serum neutrophil elastase, and pulmonary function tests including forced expiratory volume in one second (FEV₁), forced vital capacity (FVC) and FEV₁/FVC ratio.</p> <p>Results</p> <p>Serum neutrophil elastase concentration was significantly higher in both prehypertensive (405.8 ± 111.6 ng/ml) and normotensive (336.5 ± 81.5 ng/ml) obese women than in control non-obese women (243.9 ± 23.9 ng/ml); the level was significantly higher in the prehypertensive than the normotensive obese women. FEV1, FVC and FEV1/FVC ratio in both prehypertensive and normotensive obese women were significantly lower than in normal controls, but there was no statistically significant difference between the prehypertensive and normotensive obese women. In prehypertensive obese women, there were significant positive correlations between neutrophil elastase and body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, low density lipoprotein cholesterol, high sensitivity C-reactive protein and negative correlations with high density lipoprotein cholesterol, FEV1, FVC and FEV1/FVC.</p> <p>Conclusion</p> <p>Neutrophil elastase concentration is elevated in obese prehypertensive women along with an increase in high sensitivity C-reactive protein which may account for dyslipidemia and airflow dysfunction in the present study population.</p

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Efficacy of ultrasonography-guided intra-articular steroid injection of the shoulder and excercising in patients with adhesive capsulitis: Glenohumeral versus subacromial approaches

Aim of the work: To evaluate the efficacy of intra-articular steroid injection of the shoulder joint with exercises in the management of patients with adhesive capsulitis and to compare glenohumeral (GH) versus subacromial subdeltoid (SASD) ultrasound-guided approaches. Patients and methods: Forty patients with adhesive capsulitis were randomly divided into 2 groups according to injection approach. Patients received ultrasound-guided intra-articular injection methylprednisolone acetate (40 mg) and 1 ml 2% lidocaine followed by exercise for 12 weeks. Visual analog scale (VAS) for pain, the shoulder pain and disability index (SPADI) and active range of motion (ROM) were assessed before and 12 weeks post-injection. Results: The mean age of the patients was 47.3 ± 8.7 years with 12 females and 8 males in each group. After injection, there was a significant improvement of pain (VAS) and SPADI in both groups (p < 0.001). Before injection, SASD bursitis was present in 18 (45%), GH joint effusion in 14 (35%), rotator cuff tendinopathy in 6 (15%), bursitis with effusion in 1 (2.5%) and with supraspinatus tendon calcification in another (2.5%). Both groups significantly equally improved regarding to ROM compared to before injection. Post-injection, the SPADI significantly improved in the SASD group compared to GH; with remarkable improvement in the joint extension, internal and external rotation (p < 0.001). Conclusion: Intrarticular steroid injection of the shoulder joint followed by exercises in patients with adhesive capsulitis decreases pain, improves function and ROM with a more favorable response by the GH approach. Ultrasound-guided injection is an accurate, easy and cost-effective approach. Keywords: Adhesive capsulitis, Glenohumeral, Subacromial subdeltoid bursa, Ultrasound-guided injectio

Assessment of the Toxicity of Natural Oils from Mentha piperita, Pinus roxburghii, and Rosa spp. Against Three Stored Product Insects

Three natural oils extracted from Mentha piperita, Pinus roxburghii, and Rosa spp. were assessed in order to determine their insecticidal activity against the adults of three stored product insects: the rice weevil (Sitophilus oryzae L.), the lesser grain borer (Rhyzopertha dominica, Fabricius), and the red flour beetle (Tribolium castaneum, Herbst.). By Gas chromatography&ndash;mass spectrometry (GC/MS) analysis, the main compounds in the n-hexane oil from Rosa spp. were determined to be methyl eugenol (52.17%), phenylethyl alcohol (29.92%), diphenyl ether (7.75%), and geraniol (5.72%); in the essential oil from M. piperita, they were menthone (20.18%), 1,8-cineole (15.48%), menthyl acetate (13.13%), caryophyllene (4.82%), &beta;-pinene (4.37%), and D-limonene (2.81%); and from the foliage of P. roxburghii, they were longifolene (19.52%), caryophyllene (9.45%), &Delta;-3-carene (7.01%), &alpha;-terpineol (6.75%), and &gamma;-elemene (3.88%). S. oryzae and R. dominica were reared using sterilized wheat grains, and T. castaneum was reared on wheat flour mixed with yeast (10:1, w/w), all under laboratory conditions (27 &plusmn; 1 &deg;C and 65% &plusmn; 5% Relative humidity (R.H). Two toxicity bioassays were used, as well as contact using thin film residues and fumigation bioassays. The results indicated that M. piperita caused a high toxicity for S. oryzae compared to other insects. High significant variations were observed between the tested M. piperita doses against the stored insects, and this natural material could be used to control insects that infect the grains. Also, the data indicated that the Rosa spp. oil had a low-toxicity effect against these insects compared to other oils. We recommend using natural oils against the stored weevils and petals, rather than the chemical agent, so as to serve human health

Synergistic Influence of <i>Arbuscular mycorrhizal</i> Fungi Inoculation with Nanoparticle Foliar Application Enhances Chili (<i>Capsicum annuum</i> L.) Antioxidant Enzymes, Anatomical Characteristics, and Productivity under Cold-Stress Conditions

In this study, we aimed to evaluate the effects of Arbuscular mycorrhiza fungus (AMF) inoculation, foliar application of zinc oxide and selenium nanoparticles (ZnO-NPs and Se-NPs), and their combined interactions on the growth and productivity of chili pepper under cold-stress conditions. Two field experiments were successfully conducted during the winter seasons of 2021 and 2022 in an experimental field at the Faculty of Agriculture, Cairo University, Giza, Egypt. The results showed that, under cold stress, the combination of AMF inoculation and ZnO-NPs + Se-NPs as a foliar spray increased the average fruit weight by 92.4% and 98.7%, and the number of fruits by 34.6% and 54.8 compared to control treatment in the 2021 and 2022 seasons, respectively. Additionally, the combination of AMF and a mixture of nanoparticles (ZnO-NPs + Se-NPs) significantly increased the total marketable yield by 95.8% and 94.7% compared to the control, which recorded values of 2.4 and 1.9 kg m−2 in the 2021 and 2022 seasons, respectively. Furthermore, the combination of AMF and a mixture of nanoparticles (ZnO-NPs + Se-NPs) showed the highest total content of ascorbic acid and capsaicin in chili fruits compared to the other treatments. The combination of AMF and a mixture of nanoparticles (ZnO-NPs + Se-NPs) stimulated the accumulation of peroxidase (POD) and nitrogen glutamate dehydrogenase (GDH) while decreasing hydrogen peroxide (H2O2) and lipid peroxidation (MDA) contents. SDS analysis revealed that the application of ZnO-NPs, Se-NPs, AMF + ZnO-NPs, and AMF + ZnO-NPs + Se-NPs induced the emergence of new protein bands and reconstitution of those damaged by cold stress. Regarding histological structure, the combination of AMF inoculation and ZnO-NPs + Se-NPs as a foliar spray showed an enhancement in the thickness of grana thylakoids and increased the number of chloroplasts. Intriguingly, the findings showed that AMF and a mixture of nanoparticles (ZnO-NPs + Se-NPs) could offer guidance for increasing plant development and productivity under cold-stress conditions

Multimodal Interventions to Prevent and Control Carbapenem-Resistant Enterobacteriaceae and Extended-Spectrum β-Lactamase Producer-Associated Infections at a Tertiary Care Hospital in Egypt

The current rise of multidrug-resistant (MDR) Gram-negative Enterobacteriaceae including the extended-spectrum β-lactamase (ESBL)-producing organisms and carbapenem-resistant Enterobacteriaceae (CRE) has been increasingly reported worldwide, posing new challenges to health care facilities. Accordingly, we evaluated the impact of multimodal infection control interventions at one of the major tertiary healthcare settings in Egypt for the aim of combating infections by the respective pathogens. During the 6-month pre-intervention period, the incidence rate of CRE and ESBL-producing clinical cultures were 1.3 and 0.8/1000 patient days, respectively. During the post-intervention period, the incidence of CRE and ESBL producers continued to decrease, reaching 0.5 and 0.28/1000 patient days, respectively. The susceptibility rate to carbapenems among ESBL producers ranged from 91.4% (ertapenem) to 98.3% (imipenem), amikacin (93%), gentamicin (56.9%), and tobramycin (46.6%). CRE showed the highest resistance pattern toward all of the tested β-lactams and aminoglycosides, ranging from 87.3% to 94.5%. Both CRE and ESBL producers showed a high susceptibility rate (greater than 85.5%) to colistin and tigecycline. In conclusion, our findings revealed the effectiveness of implementing multidisciplinary approaches in controlling and treating infections elicited by CRE and ESBL producers

Prevalence of Pseudomonas aeruginosa in Milk and Some Dairy Products with Reduction Trials by Some Natural Preservatives

Contamination of milk and dairy products with spoilage and pathogenic microorganisms is a common problem worldwide. Therefore, this study was conducted on 200 samples (milk, Kareish cheese, Damietta cheese, and plain yoghurt, 50 of each) collected from Zagazig City, Sharkia, Egypt to be examined bacteriologically to isolate and identify the multi-drug resistant Pseudomonas aeruginosa as well as some reduction trials on cold stored soft cheese using some natural compounds including the essential oil (EO) of Clove (0.01%, 0.1%) and Nigella Sativa (NS 0.5%, 1%), in addition to Nisin (10 ppm 12.5 ppm). The obtained results revealed the pseudomonas aeruginosa prevalence in the examined milk and dairy product samples was 45(22.5%); 24(48%) from raw milk samples, 8(16%) from yoghurt, 9(18%) from soft cheese and 4(8%) from kareish cheese. The isolated Pseudomonas aeruginosa harbored some antibiotic-resistant genes including blaTEM, blaSHV, ermB, and Mcr1 genes, while blaOXA-1 failed to be detected, so it was resistant to different types of antimicrobial agents. The multiple antibiotic resistance index (MAR) of the isolated strains was 0.500. Clove (0.01%, 0.1%) and Nigella Sativa (NS 0.5%, 1%), in addition to Nisin (10 ppm, 12.5 ppm) had an antibacterial effect against Pseudomonas aeruginosa compared with control samples and acted as good preservatives that extended the storage period and shelf life of soft cheese up to thirty days

High dose dexamethasone as an alternative rescue therapy for active bleeding in children with chronic ITP: clinical and immunological effects

High-dose dexamethasone (HD-DXM) is debated as a second-line therapy for chronic Immune thrombocytopenia (ITP) in children. The aim of this study is to evaluate the efficacy and safety of HD-DXM as an emergency therapy in uncontrolled bleeding in children with chronic ITP and to assess its immunological effect on dendritic cells (DCs) percentage and their co-stimulatory markers CD86 and CD83. Totally, 20 children previously diagnosed as chronic ITP were enrolled in this study and all admitted to hospital with uncontrolled bleeding. Patients received HD-DXM as a single daily dose for 4 days. Blood samples were withdrawn from patients just prior to HD-DXM therapy and on day 5 to evaluate the platelet count and for flowcytometric analysis of DCs. Daily assessment of bleeding severity was performed. The platelet counts significantly increased in patients after 5 days of initiation of therapy compared with platelet count before therapy (p-value = 0. 0002). Control of bleeding observed in (90%), complete response (CR) documented in (50%), response (R) documented in (40%), and no response (NR) documented in (10%) of patients. The time to respond was raging from 1 to 3 days and minor complication recorded in two patients. Both plasmacytoid DCs and myeloid DCs percentage and their expression of co-stimulatory markers, CD86 and CD83 decreased significantly after HD-DXM therapy. Conclusion: short course of HD-DXM as a rescue therapy seems to be an effective alternative emergency treatment for uncontrolled bleeding in chronic ITP children especially in nations with limited resources