Evaluation of Retinal Nerve Fiber Layer Thickness in Patients with Multiple Sclerosis

Background: Multiple sclerosis (MS) is a neurodegenerative disease, and is considered a chronic inflammatory disease. Retinal nerve fiber layer (RNFL) thickness as a structural biomarker for axonal loss in MS.Objective: The aim of the present study was to assess the role of optical coherence tomography (OCT) in detecting RNFL in MS patients without history of optic neuritis and to correlate with disease duration and disease disability. Patients and methods: Case-control study included 34 patients with clinically definite relapsing remitting multiple sclerosis (RRMS) and 34 age- and sex-matched individuals (other than MS) served as the controls. They were selected from the inpatients wards and Outpatients Clinic of Neurology Department, Zagazig University Hospitals. All patients were subjected to full history taking, clinical examination as well as laboratory and specific investigations. Results: The mean age was 34.56 ± 8.79 years in MS patients and 34.03 ± 8.79 years in controls. VEP 42.9% is with delay of p100 wave in bilateral eyes, and prolongal p100 laterary in bilateral eyes in 54.3%. There was a highly statistical significant difference between groups as regard RNFL average thickness and RNFL symmetry. Expanded disability status scale (EDSS) showed independently associated with RNFL.Conclusion: The thickness of the RNFL observed by OCT in MS patients is dramatically reduced when compared to controls, according to the current study. OCT is a valuable tool for determining the thickness of the RNFL in MS patients

Study the polymorphism in UCSNP43, 44 to exon 3 of Calpain-10 gene of Polycystic Ovary Syndrome women in Thi Qar Province

The correlation between polycystic ovary syndrome (PCOS) and type-2 diabetes mellitus (T2DM) was reported regarding T2DM genes, which contribute in the pathogenesis of PCOS. The current study was aimed to investigate the association of CAPN-10 gene UCSNP-43, UCSNP-44 polymorphism with PCOS.Thirty women with PCOS and 20 healthy, which are matched in their age, were selected to test the anthropometric and biochemical profile of our samples. Nucleic acid of samples was extracted and genotype analysis was done.  The results of patients-hormonal analysis were indicated that the level of follicle stimulating hormone was low and the levels of other hormones were high in comparison to that of healthy women. Biomass (BMI) and lipid profiles of PCOS patients were higher than from these in healthy women. Haplotypes of sequenced samples were determined for each gene fragment. The same three haplotypes of SNPs-43 were identified in both PCOS and controls samples. On the other hand, high diversity of haplotypes was found from SNPs-44. The meta-analysis with fixed and random effects odds ratio (ORs) on the basis of haplotypes frequencies were presented

Study the polymorphism in UCSNP43, 44 to exon 3 of Calpain-10 gene of Polycystic Ovary Syndrome women in Thi Qar Province

The correlation between polycystic ovary syndrome (PCOS) and type-2 diabetes mellitus (T2DM) was reported regarding T2DM genes, which contribute in the pathogenesis of PCOS. The current study was aimed to investigate the association of CAPN-10 gene UCSNP-43, UCSNP-44 polymorphism with PCOS.Thirty women with PCOS and 20 healthy, which are matched in their age, were selected to test the anthropometric and biochemical profile of our samples. Nucleic acid of samples was extracted and genotype analysis was done.  The results of patients-hormonal analysis were indicated that the level of follicle stimulating hormone was low and the levels of other hormones were high in comparison to that of healthy women. Biomass (BMI) and lipid profiles of PCOS patients were higher than from these in healthy women. Haplotypes of sequenced samples were determined for each gene fragment. The same three haplotypes of SNPs-43 were identified in both PCOS and controls samples. On the other hand, high diversity of haplotypes was found from SNPs-44. The meta-analysis with fixed and random effects odds ratio (ORs) on the basis of haplotypes frequencies were presented

Parental awareness regarding pediatric antibiotic use in Madinah, Saudi Arabia

Purpose: To determine the level of awareness of antibiotic use in children in Madinah, Saudi Arabia, and to identify factors associated with parental decisions regarding it. Methods: Using a multiple-choice-question-based questionnaire survey, 1256 forms were distributed to visitors of major shopping malls in Madinah City to obtain socio-demographic and antibiotics knowledgebased data from October 2017 to January 2018. Differences in scores between and within groups on knowledge of parents about antibiotics were determined. Results: Most participants (67 %) had good basic knowledge of antibiotics: 69 and 40 % of respondents were aware of their side effects and antibacterial resistance, respectively. Participants in high age groups (> 46 years old) have a significantly higher mean knowledge score (55.4 ± 20.1, p < 0.05) than those in younger groups. Educational status increased the mean knowledge score by approximately 60 %, with the most educated group having a mean score of 61.2 ± 16.4 (p < 0.05). Conclusion: These results reveal the importance of awareness campaigns on antibiotic use and the role of healthcare professionals in the education of patients and parents on correct use of antibiotics, as well as the significance of antibacterial resistance. Keywords: Antibiotics misuse, Pediatrics, Patient education, Antibacterial resistanc

Comparative physiological, morphological, histological, and AQP2 immunohistochemical analysis of the Arabian camels (Camelus dromedarius) and oxen kidney: Effects of adaptation to arid environments

Compared to other mammals, Arabian camels are ideal models for exploring the structural adaptations that enable camels to survive in arid environments. Thus, this study aimed to explore how evolutionary adaptation to arid conditions modifies the characteristics of the kidneys in Arabian camels (Camelus dromedarius) compared to oxen. Urine samples were physically and chemically analyzed. Harvested kidneys were subjected to topographical and fast spin echo magnetic resonance (FSE-MR) imaging. Histology, histomorphometry, and Aquaporin-2 (AQP2) expression by immunohistochemistry were also performed. Here, in dromedaries, sodium and potassium values in the urine were much higher (p=0.001, for both), whereas chloride was much lower (p=0.004) than the values of oxen. Compared with oxen, the level of the hormone aldosterone in serum was significantly lower (p=0.002), whereas creatinine and urea were significantly higher (p=0.005 and p=0.001, respectively). Uric acid in dromedaries and oxen did not differ significantly (p=0.349). Like sodium levels (p=0.001) in dromedary serum, chloride was also much higher (p=0.002) than in oxen. The average value of potassium was much lower (p=0.009) than that of oxen. Morphologically, anatomical and FSE MRI studies revealed that minor and major calyces were not found in dromedary kidneys. The renal pelvis was not found in oxen, and the major calyx was directly connected to the ureter. The dromedary kidney contained a wider medullary portion as well as increased diameters for renal corpuscles (RCs), proximal convoluted tubules (PCTs), and collecting tubules (CTs, p<0.05) compared with the oxen. We also noted that AQP2 was significantly expressed in dromedary nephron components, except for RCs, compared with oxen as shown by immunohistochemistry. Overall, these data strongly suggest that the dromedary has a greater ability to adapt to harsh desert conditions in terms of producing highly concentrated urine than oxen

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Comparative Assessment of the Antioxidant and Anticancer Activities of <i>Plicosepalus acacia</i> and <i>Plicosepalus curviflorus</i>: Metabolomic Profiling and In Silico Studies

This study presents a comparison between two mistletoe plants—P. acacia and P. curviflorus—regarding their total phenolic contents and antioxidant and anticancer activities. P. curviflorus exhibited a higher total phenolics content (340.62 ± 19.46 mg GAE/g extract), and demonstrated higher DPPH free radical scavenging activity (IC50 = 48.28 ± 3.41µg/mL), stronger reducing power (1.43 ± 0.54 mMol Fe+2/g) for ferric ions, and a greater total antioxidant capacity (41.89 ± 3.15 mg GAE/g) compared to P. acacia. The cytotoxic effects of P. acacia and P. curviflorus methanol extracts were examined on lung (A549), prostate (PC-3), ovarian (A2780) and breast (MDA-MB-231) cancer cells. The highest anticancer potential for the two extracts was observed on PC-3 prostate cancer cells, where P. curviflorus exhibited more pronounced antiproliferative activity (IC50 = 25.83 μg/mL) than P. acacia (IC50 = 34.12 μg/mL). In addition, both of the tested extracts arrested the cell cycle at the Pre-G1 and G1 phases, and induced apoptosis. However, P. curviflorus extract possessed the highest apoptotic effect, mediated by the upregulation of p53, Bax, and caspase-3, 8 and 9, and the downregulation of Bcl-2 expression. In the pursuit to link the chemical diversity of P. curviflorus with the exhibited bioactivities, its metabolomic profiling was achieved by the LC-ESI-TOF-MS/MS technique. This permitted the tentative identification of several phenolics—chiefly flavonoid derivatives, beside some triterpenes and sterols—in the P. curviflorus extract. Furthermore, all of the metabolites in P. curviflorus and P. acacia were inspected for their binding modes towards both CDK-2 and EGFR proteins using molecular docking studies in an attempt to understand the superiority of P. curviflorus over P. acacia regarding their antiproliferative effect on PC-3 cancer cells. Docking studies supported our experimental results; with all of this taken together, P. curviflorus could be regarded as a potential prospect for the development of chemotherapeutics for prostate cancer

Preoperative predictive parameters for accurate detection of stage IV endometriosis

Abstract Background Surgery is the main line of treatment of endometriosis. Patients with stage IV endometriosis have more extensive adhesions, which make the surgery difficult. There are no accurate non-invasive predictive preoperative parameters of stage IV endometriosis and no consensus has been reached. Therefore, the aim of the present study was to evaluate and detect preoperative non-invasive parameters for the detection of stage IV endometriosis. Patients and methods In the present study, we included 150 females admitted for surgical removal of endometriosis. We scored and classified endometriosis into four stages according to the revised ASRM classification. We compared between baseline characteristics of patients with different stages of endometriosis, and then we selected the best combination of diagnostic and predictive parameters of stage IV endometriosis. Results Predictors of stage IV endometriosis and indicators for safety surgery were as follows: VAS ≥ 4 (p < 0.001), fixed uterus (p = 0.005), fixed ovarian cysts (p < 0.001), tender uterosacral ligament nodule (p < 0.001), tender rectovaginal septum nodule (p = 0.003), bilateral endometriosis (p < 0.001), and sum of sizes of endometriotic nodules (p < 0.001). Conclusion Fixed uterus, fixed ovarian cysts, tender uterosacral ligament nodule, tender rectovaginal septum nodule, bilateral endometriosis, and indications for surgery were significantly considered adequate predictive markers for stage IV endometriosis