Molecular characterization of extended-spectrum beta lactamase (ESBL) producing klebsiella pneumoniae and escherichia coli among hospitalized patients in Oman

Hospital-acquired infections due to ESBL-producing gram-negative rods are a worldwide healthcare problem causing substantial patient morbidity and mortality. In the Middle East, a significant increase in incidence and prevalence has been reported recently due to the misuse of antibiotics and lack of coherent antimicrobial resistance (AR) surveillance programs. The aim of the study was to determine the level of genotypic diversity and mechanism of AR of E. coli and K. pneumoniae ESBL-producing isolates from nosocomial infections among patients in Oman. 35 E. coli and 14 K. pneumoniae isolates were used in the study. Antibiotic susceptibility testing (AST) and ESBL screening was conducted via disk diffusion and E-test following CLSI (Clinical and Laboratory Standards Institute) guidelines. ESBL producers were screened for blaCTX-M, blaSHV, blaOXA, and blaTEM resistance markers via PCR. All PCR amplicons were sequenced to determine their allelic variants. In order to demonstrate overall genotypic diversity, Pulsed-Field Gel Electrophoresis (PFGE) analyses were done separately for all E. coli and K. pneumoniae isolates. 40 (80%) isolates were determined to be ESBL producing bacteria (27 E. coli and 13 K. pneumoniae). The highest level of AR (\u3e70%) was against tetracycline, ampicillin, nalidixic acid, cephalothin, and cefpodoxime. The lowest level of AR was against chloramphenicol, amikacin and ticarcillin-clavulanic acid. Resistance against imipenem was not detected. Similarity of K. pneumoniae isolates ranged from 61% to 100%. Three K. pneumoniae clusters (n= 7; 58%) had â ¥ 80% similarity suggesting high level of similarity. E. coli PFGE analyses showed an overall similarity of 64% with 4 clusters (n= 14; 54%) showing 80% similarity. No correlation was demonstrated between the AR pattern and genotypic similarity for either species. Percentages of isolates with genetic markers for blaCTX-M, blaSHV, blaTEM, and blaOXA were 73%, 24%, 68%, and 60% respectively. DNA sequencing analyses revealed that the most common AR mechanism in these ESBL isolates is due to blaCTX-M-15 marker. In addition, SHV-1, SHV-11, SHV-12, TEM-1, and OXA-1 contribute to the overall AR mechanisms in nosocomial ESBL isolates from Oman. This is the first study characterizing the AR mechanism of ESBL\u27s isolates from hospital-acquired infections in Oman. The results showed that hospital-acquired E. coli isolates from Oman are more diverse than K. pneumoniae. The blaCTX-M-15 is the most abundant mechanism conferring ESBL phenotype on E. coli and K. pneumoniae, while the ESBL-SHV-type was the least abundant

Expression analysis of liver-specific circulating micrornas in hcv-induced hepatocellular carcinoma in Egyptian patients

Introduction: The prevalence of hepatocellular carcinoma (HCC) in Africa is higher compared to the rest of the world due to the high incidence of chronic infection with hepatitis C virus (HCV). In Egypt, HCV infection is the leading cause for the high HCC incidence, which is usually diagnosed at late stages. Due to the absence of reliable and accurate biomarkers for early detection of liver cancer, circulating microRNAs have recently emerged as great candidates for early diagnosis of HCC. These small non-coding RNA molecules are responsible for regulating gene expression and RNA stability. Therefore, the aim of this study is to investigate the potential of liver-specific circulating microRNAs as an accurate non-invasive diagnostic tool for the early detection of HCV-induced HCC. Methods: Eight main miRNAs (miR-16, miR-34a, miR-122a, miR-125a, miR-139, miR-145, miR-199a, and miR-221) were selected due to their expression patterns in HCC as well as their contribution to the development of hepato-carcinogenesis. A total of 165 patients were enrolled in this study, from which serum samples were collected and categorized into four main patient groups: 42 chronic hepatitis C (CHC) without cirrhosis, 45 CHC with cirrhosis (LC), 38 HCC with HCV patients, and 40 healthy controls. The expression profile of the eight miRNAs was analyzed using TaqMan real-time reverse transcription-polymerase chain reaction. Additionally, the conventional markers for HCC α-fetoprotein (AFP) and des-γ-carboxyprothrombin (DCP) were measured using commercial kits. Results: Serum levels of miRNA-122a, miRNA-125a, miRNA-139, miRNA-145 and miRNA-199a were significantly lower (p\u3c0.01) in HCC than in both CHC and LC groups. On the other hand, no significant difference was shown in the expression of miR-16, miR-34a, and miR-221 between the CHC, LC, and HCC groups. MiR-16, miR-34a, and miR-221 were significantly elevated in the HCC group compared to the control group. MiR-122a showed the highest specificity and sensitivity, followed by miR-125a, which had the second highest specificity, indicating its significance in diagnosis. Conclusions: The results indicated that measurement of serum levels of miR-122a, miR-125a, miR-139, miR-145, and miR-199a can help to differentiate HCC from CHC and LC. Measurement of serum levels of miR-16, miR-34a, and miR-221 were shown to have a prognostic value. Highly significant correlation was established between different miRNAs within the same patient group or between two different groups, indicating a great diagnostic value for the early detection of HCC. MiR-122a had the highest specificity and sensitivity, indicating that serum miR-122a might serve as a novel and potential non-invasive biomarker for HCV-induced HCC

Ostéome ostéoïde intra-articulaire de la hanche: deux observations et revue de la littérature

L’ostéome ostéoïde est une tumeur osseuse bénigne qui affecte les adultes jeunes et se localise préférentiellement au niveau des os longs. La localisation intra-articulaire est rare et atteint le plus souvent la hanche. La symptomatologie clinique est alors atypique et peut faire errer le diagnostic constituant un défi diagnostique pour les cliniciens. Nous rapportons deux observations d’ostéome ostéoïde intra-articulaires de la hanche chez deux hommes âgés 24 et 45 ans, révélés par des douleurs de la hanche gauche de type inflammatoire évoluant depuis un an et un an et demi respectivement. Chez les deux patients, le tableau atypique de l’ostéome ostéoïde a été à l’origine d’un retard diagnostic. La tomodensitométrie est dans cette indication l’examen le plus spécifique qui a permis d’évoquer le diagnostic d’ostéome ostéoïde. Une fois le diagnostic est posé, l’exérèse chirurgicale à ciel ouvert a permis la guérison avec disparition totale des douleurs. L’examen histologique a confirmé le diagnostic final d’ostéome ostéoïde intra-articulaire dans les deux cas

Expression Analysis of Liver-Specific Circulating microRNAs in HCV-Induced Hepatocellular Carcinoma in Egyptian Patients.

Due to the absence of reliable and accurate biomarkers for the early detection of liver malignancy, circulating microRNAs have recently emerged as great candidates for prompt cancer identification. Therefore, the aim of this study was to investigate the potential of liver-specific circulating microRNAs as an accurate non-invasive diagnostic tool for early diagnosis of hepatitis C virus (HCV)-induced hepatocellular carcinoma (HCC). Methodology: A total of 165 patients were enrolled in this study and categorized into four main groups: 42 chronic hepatitis C (CHC) without cirrhosis, 45 CHC with cirrhosis (LC), 38 HCC with HCV patients, and 40 healthy controls. The expression profiles of seven miRNAs (miR-16, miR-34a, miR-125a, miR-139, miR-145, miR-199a, and miR-221) were analyzed using real-time PCR. Results: Serum levels of miRNA-125a, miRNA-139, miRNA-145, and miRNA199a were significantly lower (p \u3c 0.01) in HCC than in both CHC and LC groups. On the other hand, no significant difference was shown in the expression of miR-16, miR-34a, and miR-221 between the CHC, LC, and HCC groups. MiR-16, miR-34a, and miR-221 were significantly elevated in the HCC group compared to the control group. MiR-34a showed the highest specificity and sensitivity. Conclusions: The results indicated that the measurement of serum levels of miR-125a, miR-139, miR-145, and miR-199a can help to differentiate HCC from CHC and LC. Also, miR-16, miR-34a, and miR-221 serum levels would have a prognostic value. MiR-34a had the highest specificity and sensitivity, indicating that it might serve as a novel and potential non-invasive biomarker for HCV-induced HCC

MAIS-E2 MODEL AND R2-IBN FRAMEWORK: PORT APPLICATION CASE

This paper aims to study the problem of cooperation in the extended enterprise case. This study focuses on the presentation of agent-oriented extended enterprise as a solution allowing enterprises to overcome the cooperation problem, in general, and conflict resolution, in particular. In this regard, this objective is defined by three aspects: organizational, reasoning and application. The organizational and reasoning aspects are presented through an overview of designing the extended enterprise by an agent-oriented approach via the proposed MAIS-E2 model (Multi-Agent Information System for an Extended Enterprise) and the proposed argument-based negotiation framework R2-IBN (Relationship-Role and Interest Based Negotiation) defined for MAIS-E2 model, respectively. Then, we focus mainly on the application aspect through the instantiation of MAIS-E2 model to the port application. These aspects are consolidated by the experimental validation via the developed prototype using JADE platform and experimental results with different cases in the port area.Extended enterprise, cooperation, multi-agent systems, MAIS-E2, argument based negotiation, R2-IBN

Synthesis and Characterization of Positively Charged tris -Imidazolium Calix[6]arene Hosts for Anion Recognition

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