Genotyping of carbapenem resistant Acinetobacter baumannii isolated from Egyptian patients

Acinetobacter baumannii has recently been known as a major cause of hospital- and community-acquired infections. Carbapenem resistant A. baumanni (CRAB) has been recorded to be resistant to nearly all antibiotics, including the last resort antibiotics; carbapenems. This study aimed to detect the carbapenem resistance levels and mechanisms, in addition to the genotyping of A. baumanni in Upper Egypt. About 200 clinical samples were collected from different wards of Sohag University Hospital, Egypt, from which 20 A. baumannii isolates were recovered and then identified using conventional methods and Polymerase Chain Reaction (PCR). Antibiotic sensitivity testing was carried out using the Disk diffusion method, followed by PCR testing of the common carbapenemase-encoding genes, including OXA-51, OXA-58, KPC, GES, IMP, NDM, VIM, SIM, and GIM. Genotyping was performed using the Enterobacterial Repetitive Intergenic Consensus-Polymerase chain reaction (ERIC-PCR). About 85 % of A. baumannii strains were multidrug resistant (MDR), and high rate of Extreme drug resistant (XDR) A. baumannii (70 %) was detected. Carbapenem resistance was detected in 65 % of A. baumannii isolates, 70.58 % of MDR isolates, and 85.7 % of XDR isolates, respectively. Carbapenemase- encoding genes, including blaOXA-51, VIM, NDM, and GES, were detected in 100 %, 100 %, 76.9 2 % and 76.92 % of the carbapenem resistant A. baumannii (CRAB) isolates, respectively. The blaIMP and blaKPC genes had lower prevalence rates of 15.38 % and 30.77 %; respectively, whereas the SIM, GIM, and OXA-58 genes were not detected in any of the tested A. baumanni isolates. All of the MDR isolates carried three or more the carbapenemases encoding genes, and 85.7 % of the XDR isolates carried four or more of the carbapenemase-encoding genes. The dendrogram constructed from the ERIC-PCR results showed that the A. baumannii isolates were divided into three different clusters

Medical prospects of cryptosporidiosis in vivo control using biofabricated nanoparticles loaded with Cinnamomum camphora extracts by Ulva fasciata

Background and Aim: Global efforts are continuing to develop preparations against cryptosporidiosis. This study aimed to investigate the efficacy of biosynthesized Ulva fasciata loading Cinnamomum camphora oil extract on new zinc oxide nanoparticles (ZnONPs shorten to ZnNPs) and silver nanoparticles (AgNPs) as alternative treatments for Cryptosporidium parvum experimental infection in rats. Materials and Methods: Oil extract was characterized by gas chromatography-mass spectrometry, loaded by U. fasciata on ionic-based ZnO and NPs, and then characterized by transmission electron microscopy, scanning electron microscopy, and X-ray diffraction. Biosafety and toxicity were investigated by skin tests. A total of 105 C. parvum oocysts/rat were used (n = 81, 2–3 W, 80–120 g, 9 male rats/group). Oocysts shedding was counted for 21 d. Doses of each preparation in addition to reference drug were administered daily for 7 d, starting on post-infection (PI) day (3). Nitazoxanide (100 mg) was used as the reference drug. After 3 weeks, the rats were sacrificed for postmortem examination and histopathological examination. Two blood samples/rat/group were collected on the 21st day. Ethylenediaminetetraacetic acid blood samples were also used for analysis of biochemistry, hematology, immunology, micronucleus prevalence, and chromosomal abnormalities. Results: C. camphora leaves yielded 28.5 ± 0.3 g/kg oil and 20 phycocompounds were identified. Spherical and rod-shaped particles were detected at 10.47–30.98 nm and 18.83–38.39 nm, respectively. ZnNPs showed the earliest anti-cryptosporidiosis effect during 7–17 d PI. Other hematological, biochemical, immunological, histological, and genotoxicity parameters were significantly fruitful; hence, normalized pathological changes induced by infestation were observed in the NPs treatments groups against the infestation-free and Nitazoxanide treated group. Conclusion: C. camphora, U. fasciata, ZnNPs, and AgNPs have refluxed the pathological effects of infection as well as positively improved host physiological condition by its anticryptosporidial immunostimulant regenerative effects with sufficient ecofriendly properties to be proposed as an alternative to traditional drugs, especially in individuals with medical reactions against chemical commercial drugs

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Novel Antimicrobial Organic Thermal Stabilizer and Co-Stabilizer for Rigid PVC

Biologically active <em>N</em>-benzoyl-4-(<em>N</em>-maleimido)-phenylhydrazide (BMPH) was synthesized and its structure was confirmed by elemental analysis and various spectral tools. It was examined as a thermal stabilizer and co-stabilizer for rigid poly (vinyl chloride) at 180 °C in air. Blending BMPH with reference samples in different ratios greatly lengthens the thermal stability value and improves the extent of discoloration of PVC. TGA confirmed the improved stability of PVC in presence of the investigated organic stabilizer. GPC measurements were done to investigate the changes occurred in the molecular masses of the degraded samples of blank PVC and PVC in presence of the novel stabilizer. BMPH showed good antimicrobial activity towards two kinds of bacteria and two kinds of fungi

Predicting Electricity Consumption in the Kingdom of Saudi Arabia

Forecasting energy consumption in Saudi Arabia for the period from 2020 until 2030 is investigated using a two-part composite model. The first part is the frontier, and the second part is the autoregressive integrated moving average (ARIMA) model that helps avoid the large disparity in predictions in previous studies, which is what this research seeks to achieve. The sample of the study has a size of 30 observations, which are the actual consumption values in the period from 1990 to 2019. The philosophy of this installation is to reuse the residuals to extract the remaining values. Therefore, it becomes white noise and the extracted values are added to increase prediction accuracy. The residuals were calculated and the ARIMA (0, 1, 0) model with a constant was developed both of the residual sum of squares and the root means square errors, which were compared in both cases. The results demonstrate that prediction accuracy using complex models is better than prediction accuracy using single polynomial models or randomly singular models by an increase in the accuracy of the estimated consumption and an improvement of 18.5% as a result of the synthesizing process, which estimates the value of electricity consumption in 2030 to be 575 TWh, compared to the results of previous studies, which were 365, 442, and 633 TWh

The effect of cholinesterase inhibition on liver dysfunction in experimental acute liver failure

Introduction: Acute liver failure (ALF), like sepsis, is associated with an overwhelming activation of the immune response in which hepatic and circulating inflammatory cytokines play a pivotal role. Cholinesterase inhibition has been shown to have anti-inflammatory properties in experimental sepsis. We investigated the role of neostigmine in attenuating d-galactosamine (d-GalN)-induced ALF. Methods: Thirty-six female wistar rats were randomly allocated to three groups: a control group, a d-GalN group receiving a single i.p. injection of d-galactosamine (400 mg kg−1 BW) and a neostigmine-treated d-GalN group receiving a single i.p. injection of d-galactosamine followed 24 h later by i.p. injection of neostigmine methylsulfate 0.25% (80 μg kg−1 BW) three times daily for 3 successive days. Rats were sacrificed 24 h after the last injection. Plasma levels of liver transaminases, total proteins, albumin, prothrombin, total bilirubin and hepatic levels of superoxide dismutase and malondialdehyde were measured. Liver expression of cytokines (HMGB-1, TNF-α and IL-10) and histopathology were evaluated. Results: Neostigmine attenuated liver dysfunction and improved liver synthetic and excretory functions, reduced proinflammatory cytokine HMGB1 (95% CI 0.33–1.09) and TNF-α (95% CI 1.26–2.06) expression compared to d-GalN group (95% CI 2.67–4.73 and 7.33–14.53, respectively, P < 0.001) and increased expression of the anti-inflammatory cytokine IL-10 in liver tissue (95% CI 2.49–4.17 vs 0.04–0.21 in d-GalN group, P < 0.001). Neostigmine also significantly increased antioxidant level, and decreased oxidative burden caused by d-GaIN. Conclusion: Neostigmine improved liver function in a rat ALF model through an anti-inflammatory activity

Progressive muscle relaxation technique effectiveness on pain and fatigue among post-mastectomy women: A quasi-experimental study

Background: Post-Mastectomy Pain (PPMP) and fatigue are common conditions that can follow surgeries for breast cancer, the most common cancer in women. The progressive muscle relaxation technique appears to be effective, affordable, low-risk, adaptable, and simple to use. Because of the frequency of PPMP and its potential severity, it has received increasing research attention. Aim:&nbsp; To evaluate the effectiveness of progressive muscle relaxation techniques on pain and fatigue among post-mastectomy women. Design: A quasi-experimental design was used to conduct this study. Setting: The study was conducted at the inpatient and outpatient clinic of Sohag Oncology institution. Subject: A purposive sampling technique was enrolled to select a sample of 50 post-mastectomy women who were randomly assigned into two equal groups, with 25 post-mastectomy women in each group (the experimental and control groups). Tools: Three tools were used (I) demographic data of Post mastectomy women sheet, (II) a Visual Analogue Scale, and (III) a fatigue assessment scale. Results: The current study revealed that the majority of post-mastectomy women in the intervention group experienced mild pain and fatigue reduction during the post-test compared to the control group