Fungal Urinary Tract Infection in Burn Patients‎

المقدمة: ان التهاب المسالك البولية هو اكثر انواع الالتهابات المكتسبة من المستشفيات شيوعأ. تعتبر الفطريات سبب غير تقليدي لحدوث التهاب المسالك البولية في الاشخاص الاصحاء, لكنها تكون سبب رئيسي لدى المرضى الراقدين في المستشفيات او في المرضى المصابين بامراض مهيئة للالتهاب او المصابين بالشذوذ الهيكلي للكلى والمسالك البولية. ان المرضى المصابين بالحروق يكونون عرضة للاصابة بعدوى المستشفيات بسبب نقص المناعة الناجم عن الحرق, اصابة الجلد والقناة التنفسية, طول فترة البقاء في وحدة العناية المركزة واستعمال المضادات الحيوية الواسعة الطيف. المواد والطرائق: تضمنت الدراسة عدد من المرضى البالغين من كلا الجنسين المصابين بدرجات مختلفة من حروق الجسم. تم تجميع الادرار لكل مريض في وقت الدخول الى المستشفى ومن ثم اسبوعيأ لمدة 6 اسابيع وارساله الى فحص تحليل الادرار العام وزرع الادرار لاختبار نمو الفطريات. تم اعتبار المرضى الذين اصيبوا بالتهاب المسالك البولية الفطري خلال فترة رقودهم في المستشفى والذين هم بالاصل غير مصابين بهذا الالتهاب وقت الدخول الى المستشفى على انهم العينة الاساسية التي استخلصت منها نتائج الدراسة الحالية. النتائج: 28 (18.6%) مريض ظهرت لديهم نتائج زرع الفطريات موجبة خلال فترة رقودهم في المستشفى, منهم 17 انثى و 11 ذكر. غالبية اعمار المرضى كانت تتراوح بين 41-50 سنة وكان معدل الاعمار ± الانحراف المعياري (44.4 ± 10.7 سنة). اكثر انواع الفطريات المسببة للالتهاب كان    Candida albicans بنسبة 64.3%, يليه  Candida glabrata بنسبة 21.4% ثم Candida tropicalis بنسبة 7.1%. حدث الالتهاب عند غالبية المرضى في الاسبوعين الثاني والثالث خلال فترة رقودهم, على الرغم من ذلك فان بعض المرضى الذين كانت لديهم نسبة حروق الجسم اكثر من 40% اصيبوا بالالتهاب في وقت مبكر وذلك خلال الاسبوع الاول من الرقود. في هذه الدراسة وجد أن الجنس الانثوي, قسطرة الاحليل و داء السكري هي اكثر عوامل الخطر المؤدية الى زيادة نسبة الالتهاب حيث كانت قيمة P 0.03, 0.005 و 0.004 على التوالي. الاستنتاج: ان التهاب المسالك البولية الفطري يحدث بنسبة 18.6% لدى المرضى المصابين بالحروق. اكثر انواع الفطريات المسببة للالتهاب هو candida species. يعتبر تقدم العمر, الجنس الانثوي, النسب العالية من حروق الجسم, قسطرة الاحليل و داء السكري اكثر عوامل الخطر المسببة لهذا الالتهاب.Background: Urinary tract infection is the most common hospital-acquired infection. Fungal species are unusual causes of urinary tract infection in healthy individuals, but common in the hospital setting or among patients with predisposing diseases and structural abnormalities of the kidney and collecting system. Burn patients are susceptible to nosocomial infections owing to the immunocompromising effects of burn injury, cutaneous and respiratory tract injury, prolonged intensive care unit stays and broad-spectrum antibiotic therapy. Objective: The study population includes adult patients of both genders who presented with different percentages of body burns. Urine sample was collected from each patient at the time of admission and weekly thereafter for 6 weeks and sent for general urine examination and urine culture to test for the possibility of fungal growth. Those who found to develop fungal UTI by urine culture during their hospitalization and had no infection at the time of admission were selected as subjects for our study. Results: 28 (18.6%) patients had positive fungal culture during their hospitalization, 11 of them were males and 17 were females, the most common age of presentation was 41-50 years and the mean age ± SD was (44.4 ± 10.7) years. The most common isolated fungi were Candida albicans (64.3%), followed by Candida glabrata (21.4%) and Candida tropicalis (7.1%). The majority of patients developed infection within the 2nd and 3rd weeks of hospitalization, however, those who presented with total body surface area burned > 40% developed an earlier infection within the 1st week. Female gender, urethral catheterization and diabetes mellitus were significantly associated with higher risk of infection as the P values were 0.03, 0.005 and 0.004 respectively. Conclusion: Fungal urinary tract infection occurred in 18.6% of burn patients. The most common causative fungi are candida species. Advanced age, female gender, high percentage of body burn, urethral catheterization and diabetes mellitus were identified as the most common risk factors of such infectio

A comparative study to evaluate the role of inhaled steroid versus low-dose oral steroid in patients of chronic obstructive pulmonary disease

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of death and disability worldwide. Its prevalence is increasing globally, especially in countries with high frequencies of smoking combined with significant environmental exposures to pollutants and biomass smoke. Currently COPD is the third leading cause of death worldwide, after ischemic heart disease and stroke. Efforts have been made to design a standard protocol for treatment of the disease, and these efforts are still in the process.Methods: The study was done on 100 subjects to assess whether steroid (inhaled or oral) actually have any role in decreasing the decline in forced expiratory volume in 1 sec and to compare the effect of both to find out which one is superior. Patients were divided into two arms, inhaled steroids group (according to GOLD guidelines), and the other group was oral prednisolone 10 mg in addition to standard treatment except inhaled steroid. The effects were studied with appropriate statistical tests.Results: Our study data showed that oral steroids are more effective on symptom control as compared to inhaled steroids. Symptoms such as cough (64% vs. 82%) and breathlessness (76% vs. 94%) significantly improved in the oral corticosteroids group. The rate of exacerbation also improved (22% vs. 12%) in the test group.Conclusion: The use of steroids has ever been a subject of divergence of views ever since its role in the treatment of COPD was first described. Although, overall steroid in any form is beneficial in symptomatic/subjective and objective improvements in COPD, oral steroids stand a better chance as compared to inhaled steroids

Evaluation of FOXM1 inhibitor (FDI-6) as a potential therapeutic molecule for small cell lung cancer

Lung cancer is the leading cause of cancer deaths accounting for about 22% of all cancer related cases in both males and females. Lung cancers are broadly grouped into two types mainly small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) with SCLC accounting for about 15% of all lung cancer cases. SCLC is different from NSCLC because in most cases it originates centrally in the bronchi and is frequently seen in smokers. SCLC is aggressive and one of the most malignant forms of tumor characterized by uncontrolled rapid growth of certain cells in the lungs. SCLC displays poor prognosis because of early-stage metastasis, acquisition of chemoresistance, and has a high rate of recurrence. One of major drivers of chemoresistance is the transcription factor Forkhead box protein M1 (FOXM1) that is responsible for modulating cell cycle proliferation, maintenance of genomic stability, DNA damage response, and cell differentiation in numerous tumor entities. In order to explore properties of SCLC cancer cell lines, human non-bone metastatic SBC3, bone metastatic SBC5, H1688, and murine (RPM) cells were treated with a FOXM1 inhibitor known as FDI-6. As a transcription factor FOXMI binds sequence-specific motifs on DNA through its DNA-binding domain activating proliferation and differentiation-associated genes. Anomalous overexpression of FOXMI is a crucial characteristic in oncogenesis and the development of SCLC. FDI-6 is a novel small molecule inhibitor of FOXM1, and it works by binding directly to FOXM1 protein, to displace FOXM1 from genomic targets in SCLC cells prompting concomitant translational downregulation. Functional assays performed confirm that FDI-6 is a viable FOXMI inhibitor showing therapeutic efficacies in SCLC.https://digitalcommons.unmc.edu/surp2021/1044/thumbnail.jp

Quantitative shadow compensated optical coherence tomography of choroidal vasculature

Conventionally rendered optical coherence tomography (OCT) images of the posterior segment contain shadows which influence the visualization of deep structures such as the choroid. The purpose of this study was to determine whether OCT shadow compensation (SC) alters the appearance of the choroid and the apparent choroidal vascularity index (CVI), an OCT-derived estimated ratio of luminal to total choroidal volume. All scans were shadow compensated using a previously published algorithm, binarized using a novel validated algorithm and extracted binarized choroid to estimate CVI. On 27 raw swept-source OCT volume-scans of healthy subjects, the effect of SC on CVI was established both qualitatively and quantitatively. In shadow compensated scans, the choroid was visualized with greater brightness than the neurosensory retina and the masking of deep tissues by retinal blood vessels was greatly reduced. Among study subjects, significant mean difference in CVI of -0.13 was observed between raw and shadow compensated scans. Conventionally acquired OCT underestimates both choroidal reflectivity and calculated CVI. Quantitative analysis based on subjective grading demonstrated that SC increased the contrast between stromal and luminal regions and are in agreement with true tissue regions. This study is warranted to determine the effects of SC on CVI in diseased eyes

In silico CD4+, CD8+ & humoral immunity associated antigenic epitope prediction and HLA distribution analysis of HTLV-I

Purpose: The linkage of human T-cell leukemia virus type 1 (HTLV-1) to fatal diseases is a well known fact for many years. However, there has been no significant progress in the field of the treatment that can lead to the development of a successful vaccine. Furthermore, there are no means of assessing the risk of disease and its prognosis in the infected people. Methods:The current study has taken the cognizance of the importance of host’s immune response in reducing the risk of infectious diseases to carry out immunoinformatics driven epitope screening strategy of vaccine candidates against HTLV-1. In this study, a genetic variability and HLA distribution analysis among the documented HTLV-1 genotypes I, II, III, IV, V & VI was performed to ensure the coverage of the vast majority of population, where vaccine would be employed. The meticulous screening of effective dominant immunogens was done with the help of ABCPred and Immune Epitope Database. Results: The results showed that the identified epitopes might be protective immunogens with high conservancy and potential of inducing both protective neutralizing antibodies and Tcell responses. The peptides “PSQLPPTAPPLLPHSNLDHI”, “PCPNLVAYSSYHATY”, and “YHATYSLYLF”, were 100% conserved among different isolates from far and wide separated countries, suggesting negligible antigenic drift in HTLV-1. Conclusions: Overall, the mentioned epitopes are soluble, non-toxic suitable candidates for the development of vaccine against HTLV-1 and warrant further investigation and experimental validation

A Database Study of Visual Outcomes and Intraoperative Complications of Postvitrectomy Cataract Surgery

PURPOSE: To analyze the visual outcomes and rate of intraoperative complications of phacoemulsification surgery after prior pars plana vitrectomy (PPV). DESIGN: Retrospective, multicenter database study. PARTICIPANTS: Eyes that underwent phacoemulsification between June 2005 and March 2015 at 8 sites in the United Kingdom. METHODS: Study eyes were classified as vitrectomized (prior PPV group) or nonvitrectomized (reference group) depending on the vitreous state at the time of cataract surgery. Eyes with multiple intraocular surgeries or history of ocular diseases known to cause cataract progression or increased risk of intraoperative complications during phacoemulsification were excluded. MAIN OUTCOME MEASURES: Logarithm of the minimum angle of resolution (logMAR) visual acuity (VA), rate of intraoperative complications, and time interval to cataract surgery. RESULTS: Eyes in the prior PPV group (n = 2221) had worse preoperative logMAR VA (0.96±0.60 vs. 0.62±0.52, P \u3c 0.0001), were from younger patients, and had longer axial lengths than the nonvitrectomized group (n = 136 533). At all postoperative time points measured up to 24 weeks, mean vision was poorer in the prior PPV group (0.41±0.47 vs. 0.17±0.29 at 4-12 weeks, P \u3c 0.0001) and a smaller proportion of eyes achieved postoperative VA ≤0.30 logMAR (Snellen, ≥20/40) (60.8% vs. 86.5% at 4-12 weeks, P \u3c 0.0001). The rate of posterior capsular rupture was not different between the prior PPV (1.5%) and the nonvitrectomized (1.7%) groups, but the incidences of zonular dialysis (1.3% vs. 0.6%) and dropped nuclear fragments (0.6% vs. 0.2%) were higher in the prior PPV group (P \u3c 0.0001). The mean time interval between PPV and cataract surgery was 399 days. CONCLUSIONS: We found a significant improvement in VA with postvitrectomy cataract surgery. However, compared with eyes without prior PPV, there was a worse mean postoperative vision of 0.2 logMAR units, a higher rate of zonular dialysis and dropped nuclear fragments, and a similar rate of posterior capsule rupture

Continuous security in DevOps environment: Integrating automated security checks at each stage of continuous deployment pipeline

In this digital transformation, when the world is witnessing record security breaches, and hackers are getting bolder and more sophisticated, the development of software quickly is not enough; however, an organization must secure the applications also. To get the secure application out of delivery team hands organization must make security not only a priority but also a standardized part of a daily operational procedure. It will be possible only when an organization integrates security checks and practices throughout the software development lifecycle to better defend their applications and protect their brand values. Therefore, this thesis has outlined a secure DevOps delivery workflow to achieve continuous security by infusing security controls, tools, compliance, and industry best practices, and automated security checks at each stage of the software development cycle, so that all the security testing is done seamlessly through a continuous delivery pipeline. Secure DevOps delivery workflow designed in this thesis will allow organizations to make security as standardized part of a daily operational procedure and results into resilient organization and culture of “everyone responsible for security,” “Scaling through automation,” and “Measurable outcomes.” Moreover, it will save team effort to put into building a better, faster, cheaper and more secure product with a focus on delivery of customers centric features instead of fighting with security-related bugs and compliances and fend off more attacks, leading to an overall more protected system. The secure seven-stage workflow gateway presented in this thesis are Requirements, Plan, Secure Develop, Build, Test, Deploy and Continuous Monitoring fully integrated with security checks at each stage. It is applicable and relevant to all DevOps enabled organization to improve productivity, organizational security learning, shift security to the left, and transform the application release cycle to produce more secure applications. At the end of this thesis, its outline, The Secure DevOps work value stream, to help DevOps team members to evaluate proposed seven-stage gateway workflow and provide everyone in the value stream with the fastest possible feedback about the security of what they are creating, enabling them to quickly detect and correct security problems as part of their work, which enables learning and prevents future errors. Security testing DevOps toolchain, set of security tools integrated within Continuous deployment pipeline to auto checks security at each stage of the workflow, to help the delivery team identify and fix flaws earlier in the delivery process before flaws exposed to the public without impeding agility and this shift security to the left. Secure DevOps workflow model by building security into every stage of the secure development life cycle, from the security requirements stages onwards, and this makes everyone responsible for security. Contributions of this thesis consist of: a secure seven-stage continuous security workflow infused with security controls, compliances and best practices; flow of work across continuous security value stream; Anatomy of continuous security assurance model; Toolchain to infuse automated security checks during CI/CD pipeline.8

The role of Islamic banks in society

Abstract not available

Business precepts of Islam: the lawful and unlawful business transactions according to Shariah

The lawful or permissible (halal) and unlawful or prohibited (haram) transactions in Islamic jurisprudence (fiqh) are presented in this chapter. The rationale behind all of these tenets of business practices in Islamic economic system is bound by the fact that everything that is good and beneficial for the society is lawful and permissible and anything that causes harm or menace to the society is unlawful and prohibited. This is the foundation of Islamic business precept and quintessentially forms the ethical system in Islam. Some of the general rulings regarding the tenets of business transactions will be discussed in light of the Shariah-Islamic social/legal system and the basis for such decrees