Accumulation of Trace Metals, Petroleum Hydrocarbons, and Polycyclic Aromatic Hydrocarbons in Marine Copepods from the Arabian Gulf

In this study, zooplankton samples were collected from the coastal waters of Qatar during winter and summer 1998 to assess the impact of growing industrialization on the bioaccumulation of trace metals, total petroleum hydrocarbons (TPHCs) and polycyclic aromatic hydrocarbons (PAHs) in copepods, the dominant zooplankton group and main food for fish in the Arabian Gulf

Molecular and serological techniques for the diagnosis of culture negative infective endocarditis in Alexandria Main University Hospital

AbstractBackground and aimCulture-negative infective endocarditis (CNIE) is a diagnostic dilemma. The study was carried out to estimate the prevalence of CNIE among definite IE cases, to describe the epidemiologic and clinical characteristics of CNIE patients and to diagnose the microbial etiology of CNIE using molecular and serological techniques.Subjects and methodsSixty-five definite IE cases were enrolled in a prospective observational study between January and December 2010. CNIE cases were tested by 16SrRNA and seminested PCR for 35 blood samples, serological tests and the study of ten valve tissue specimens.ResultsCNIE constituted 39 (60%) cases. The mean age of CNIE patients was 31years. Male to female ratio was 2.9:1. Healthcare associated IE accounted for 15.4%, native valve IE for 66.7% and intravenous drug abuse for 20.5% of cases. The mitral valve was the most frequently involved (56.4%). Out of 39 CNIE cases, seminested blood PCR detected 12 cases (ten Staphylococci, two Streptococci). Five cases were reactive by serology (three Bartonella, one Coxiella, and one Brucella). Six cases were positive by analysis of valve tissue (three Staphylococci, three Streptococci). The combined results of all diagnostic tools decreased the percentage of non-identified causes of CNIE from 60% to 24.6%.ConclusionsOur data underlined the role of collecting blood culture before starting antibiotics and the role of seminested PCR in the diagnosis of conventional causes of CNIE. The importance of serology to identify non conventional causes was also highlighted

International longitudinal registry of patients with atrial fibrillation and treated with rivaroxaban: RIVaroxaban Evaluation in Real life setting (RIVER)

Background Real-world data on non-vitamin K oral anticoagulants (NOACs) are essential in determining whether evidence from randomised controlled clinical trials translate into meaningful clinical benefits for patients in everyday practice. RIVER (RIVaroxaban Evaluation in Real life setting) is an ongoing international, prospective registry of patients with newly diagnosed non-valvular atrial fibrillation (NVAF) and at least one investigator-determined risk factor for stroke who received rivaroxaban as an initial treatment for the prevention of thromboembolic stroke. The aim of this paper is to describe the design of the RIVER registry and baseline characteristics of patients with newly diagnosed NVAF who received rivaroxaban as an initial treatment. Methods and results Between January 2014 and June 2017, RIVER investigators recruited 5072 patients at 309 centres in 17 countries. The aim was to enroll consecutive patients at sites where rivaroxaban was already routinely prescribed for stroke prevention. Each patient is being followed up prospectively for a minimum of 2-years. The registry will capture data on the rate and nature of all thromboembolic events (stroke / systemic embolism), bleeding complications, all-cause mortality and other major cardiovascular events as they occur. Data quality is assured through a combination of remote electronic monitoring and onsite monitoring (including source data verification in 10% of cases). Patients were mostly enrolled by cardiologists (n = 3776, 74.6%), by internal medicine specialists 14.2% (n = 718) and by primary care/general practice physicians 8.2% (n = 417). The mean (SD) age of the population was 69.5 (11.0) years, 44.3% were women. Mean (SD) CHADS2 score was 1.9 (1.2) and CHA2DS2-VASc scores was 3.2 (1.6). Almost all patients (98.5%) were prescribed with once daily dose of rivaroxaban, most commonly 20 mg (76.5%) and 15 mg (20.0%) as their initial treatment; 17.9% of patients received concomitant antiplatelet therapy. Most patients enrolled in RIVER met the recommended threshold for AC therapy (86.6% for 2012 ESC Guidelines, and 79.8% of patients according to 2016 ESC Guidelines). Conclusions The RIVER prospective registry will expand our knowledge of how rivaroxaban is prescribed in everyday practice and whether evidence from clinical trials can be translated to the broader cross-section of patients in the real world

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

‫املتوسط‬ ‫لرشق‬ ‫الصحية‬ ‫املجلة‬ ‫عرش‬ ‫التاسع‬ ‫املجلد‬ ‫الثاين‬ ‫العدد‬ Factors affecting defaulting from DOTS therapy under the national programme of tuberculosis control in Alexandria, Egypt ‫يف‬ ‫السل‬ ‫ملكافحة‬ ‫الوطني‬ ‫الربنامج‬ ‫ضمن‬ ‫(دوتس)‬ ‫

ABSTRACT This unmatched case-control study aimed to identify factors affecting default from therapy under the national programme of TB control in Alexandria, Egypt. Record reviews and structured interviews were made with 57defaulters and 187 randomly selected controls. Univariate analysis showed 13 out of 54 factors investigated were significantly associated with defaulting and, after stepwise logistic regression, 5 factors remained in the model: younger age (adjusted OR= 0.16), rural area of residence (OR = 12.9), long waiting times (OR = 5.81), poor physician-patient communication (OR = 3.06) and fear of information leakage (OR = 3.62). Reasons cited by defaulters included long distance to the clinic, unsuitable clinic times and long waiting times. The main factors associated with defaulting from the national programme of TB control in Alexandria, Egypt were service-related factors, which are amenable to improvement. RÉSUMÉ La présente étude cas-témoins non appariés visait à identifier les facteurs influant sur l'abandon du traitement dans le cadre du programme national de lutte antituberculeuse à Alexandrie (Égypte). Les dossiers médicaux de 57 patients ayant abandonné le traitement et de 187 témoins sélectionnés aléatoirement ont été examinés puis des entretiens structurés ont été menés. Une analyse univariée a démontré que 13 facteurs étudiés sur 54 étaient significativement associés à un abandon et, après une analyse de régression logistique par étapes, cinq facteurs ont été dégagés à partir du modèle : un âge plus jeune (OR ajusté = 0,16), un lieu de résidence en milieu rural (OR = 12,9), un long temps d'attente (OR = 5,81), une mauvaise communication entre le médecin et le patient (OR = 3,06) et la crainte de la divulgation d'informations (OR = 3,62). Une longue distance pour atteindre l'établissement de soins, des horaires d'ouverture peu pratiques et de longs temps d'attente comptaient parmi les raisons citées par les patients ayant abandonné le traitement. Les principaux facteurs associés à un abandon du traitement dans le cadre du programme national de lutte antituberculeuse à Alexandrie (Égypte) relevaient du domaine des services se prêtant aux améliorations

Phytoplankton-zooplankton relations in three inland seas along the Qatari coast (Arabian Gulf)

Phyloplankton and zooplankton community structures and abundance were studied in three inland seas around Qatar, two along the eastern coast and one along the northwestern coast. Despite some irregularities, the direct relationship between phytoplankton and zooplankton in both seasons indicates that despite of the oligotrophic nature of the inland seas and consequently the low diversity of species, the zooplankton community density is dependent, with different magnitudes, on the density of the phytoplankton community. Multiple regression analysis indicated that at the time where permissible pollution limits were not exceeded, salinity is the main factor controlling zooplankton distribution in the inland seas, followed by phytoplankton. © 2005 Taylor & Francis

دراسة مقدرة بعض الفطريات على تحليل حمض البوليك

Twenty nine species of fungi have been tested for their uricase activity. Only twenty two species of them have the ability to produce uricases. Most of the uncapable fungi to produce uricases belong to Basidiomycotina. The highest production of uricase was achieved by Aspergillus carbonarius, Botrytisfabae and Aspergillus sydowii (0.16, 0.13, and 0.093 units/ml/min.). All the cultivated mushrooms tested have uricase activity. Pleurotus sajor-caju has the highest uricase activity within all the cultivated mushrooms tested. The tested fungi proved that there is no correlation between the uricase production and the mycelial dry weight.في هذه الدراسة تم اختبار نشاط إنزيم اليوريكيز لعدد 29 نوعاً من الفطريات ، وقد تبين أن 22 نوعاً منها لها القدرة على إنتاج إنزيم اليوركيز ووجد أن معظم الفطريات البازيدية المختبرة غير قادرة على إنتاج إنزيم اليوريكيز . واتضح من الدراسة أن أعلى إنتاج لإنزيم اليوريكيز تم بواسطة الفطريات الناقصة خاصة أسبر جيلس كربونيرياس ، بوتريتس فابي وأسبر جيلس سيداوي (16 ، 0 ، 13 ، . ، 9 . ، . وحدة/ مل /دقيقة ). وقد وجد أيضاً أن كل فطريات عش الغراب المختبرة قد أعدت نشاطا لإنزيم اليوريكيز وكان أقصاها لفطرة بليوروتس - ساجور كاجوي . وثبت من الدراسة كذلك أنه لا توجد علاقة بين إنتاج إنزيم اليوريكيز وبين الوزن الجاف للفطريات المختبرة