Recurrent facial keratoacanthoma in a patient with diabetes: a case report

BACKGROUND: Keratoacanthoma is a relatively common low-grade malignancy that originates in the pilosebaceous glands. Pathologically, it closely resembles squamous cell carcinoma. Keratoacanthoma is believed to have a good prognosis; however, it has been reclassified as squamous cell carcinoma, keratoacanthoma type, to reflect the difficulty in histologic differentiation of this lesion as well as its uncommon but potentially aggressive nature. Keratoacanthoma infrequently presents as multiple tumors and may enlarge (5–15 cm), become locally aggressive, and rarely metastasize. CASE PRESENTATION: A 66-year-old Arab male patient with diabetes was referred to the Maxillofacial Surgery Department with a chief complaint of a dome-shaped nodule with a smooth, shiny surface and central crateriform ulceration with a keratin plug in the form of a horn-like projection. Skin papules were present in the right lateral canthal area and extended to the lateral border of the lower eyelid, measuring 1.3 cm. On palpation, the lesion was firm, movable, and tender. The patient had a history of a similar lesion in another area of his face that had spontaneously regressed. CONCLUSION: Histological differentiation between keratoacanthoma and well-differentiated squamous cell carcinoma is difficult, particularly when a secondary infection is present. Careful establishment of the correlation among the history, clinical findings, and histopathology is highly indicated to avoid unnecessary surgical intervention

Entomopathogenic fungi as a biological control for the Greater melon fly Dacus frontalis (Becker) (Diptera: Tephritidae)

PhD ThesisThe Greater melon fly Dacus frontalis is one of the most economically damaging pests of cucurbit fruits in Africa. The aim of this study was to evaluate entomopathogenic fungi for use against D. frontalis and develop better strategies in using these biological agents for integrated fly management. Laboratory experiments were conducted to evaluate the pathogenicity of some commercial biopesticides based on several strains of entomopathogenic fungi against different life stages of the fly. Met52 Granular biopesticide (MET52) based on Metarhizium anisopliae caused the greatest pathogenicity to the adults. Therefore, MET52 was selected for further investigation. Pupal age and an increasing rate of MET52 had no effect on pupal mortality. However, post-emergence mortality increased when the fungus was applied on young pupae. Prior application of MET52 in a granule form caused considerable mortality to larval-pupal stages compared with a drench application. A sublethal effect of MET52 infection, reducing adult reproduction, was found. The fungus was more effective when applied as a granule in soil against emerging adults than as a direct spray against adults. MET52 fungus was able to persist in soil, reducing the adult emergence and subsequent fly population for more than two months after a single application, and also inducing new infections among the fly population. Percentage mortality of untreated females mating with inoculated males was greater than that of untreated males mating with inoculated females. The infection reduced the adult’s reproduction resulting in a considerable reduction in pupae recovered in the fungal treatments. Alone or in combination with MET52 neem had a dose-dependent effect on larval mortality and induced various effects on soil stages and adults of the fly. The efficacy of the fungus increased considerably at low concentration of neem showing the shortest LT50. In field cage trials, baited McPhail traps with yeast hydrolysate enzymatic had the greatest number of D. frontalis. MET52 gave lower adult mortality than insecticide. In conclusion, soil application of MET52 can be a promising effective control of D. frontalis, and can be combined with other control agents providing a possible effective strategy for integrated fly management.Libyan governmen

A Randomized Controlled Trail Comparing the Efficacy of 0.5% Centbucridine to 2% Lignocaine as Local Anesthetics in Dental Extractions

The development of local anesthesia in dentistry has marked the beginning of a new era in terms of pain control. Lignocaine is the most commonly used local anesthetic (LA) agent even though it has a vasodilative effect and needs to be combined with adrenaline. Centbucridine is a non-ester, non amide group LA and has not been comprehensively studied in the dental setting and the objective was to compare it to Lignocaine. This was a randomized study comparing the onset time, duration, depth and cardiovascular parameters between Centbucridine (0.5%) and Lignocaine (2%). The study was conducted in the dental outpatient department at the Government Dental College in India on patients attending for the extraction of lower molars. A total of 198 patients were included and there were no significant differences between the LAs except those who received Centbucridine reported a significantly longer duration of anesthesia compared to those who received Lignocaine. None of the patients reported any side effects. Centbucridine was well tolerated and its substantial duration of anesthesia could be attributed to its chemical compound. Centbucridine can be used for dental procedures and can confidently be used in patients who cannot tolerate Lignocaine or where adrenaline is contraindicated

Effect of recombinant human erythropoietin and doxorubicin in combination on the proliferation of MCF-7 and MDA-mb231 breast cancer cells

Patients with cancer often exhibit signs of anemia as the result of the disease. Thus, cancer chemotherapies often include erythropoietin (EPO) in the regime to improve the survival rate of these patients. The aim of the present study was to determine the effect of EPO on doxorubicin-treated breast cancer cells. The cytotoxicity of doxorubicin alone or in combination with EPO against the MCF-7 and MDA-MB 231 human breast cancer cells were determined using an MTT cell viability assay, neutral red (NR) uptake assay and lactate dehydrogenase (LDH) assay. The estimated half maximal inhibitory concentration values for doxorubicin and the combination of doxorubicin with EPO were between 0.140 and 0.260 µg/ml for all cells treated for 72 h. Treatment with doxorubicin in combination with EPO led to no notable difference in cytotoxicity, compared with treatment with doxorubicin alone. The antiproliferative effect of doxorubicin at a concentration of 1 µg/ml on the MDA MB 231 cells was demonstrated by the decrease in viable cells from 3.6x10(5) at 24 h to 2.1x10(5) at 72 h of treatment. In order to confirm apoptosis in the doxorubicin-treated cells, the activities of caspases-3/7 and 9 were determined using a TBE assay. The results indicated that the activities of caspases-3/7 and 9 were significantly elevated in the doxorubicin-treated MDA-MB-231 cells by 571 and 645%, respectively, and in the MCF 7 cells by 471 and 345%, respectively, compared with the control cells. EPO did not modify the effect of doxorubicin on these cell lines. The results of the present study suggested that EPO was safe for use in combination with doxorubicin in the treatment of patients with breast cancer and concurrent anemia

The impact of BIM authoring tools on the architectural profession in Jordan

Building Information Modeling (BIM) technologies have attracted much research attention, especially in the last fifteen years. The prospects and benefits that BIM promises for all participants in the design, construction and operation of buildings are hopeful and enthusiastic. Nevertheless, the global adoption of BIM has been slow and uneven. A bibliometric analysis shows that BIM research is concentrated in a few centers and performed by a narrow group of specialists. As a result, there are research areas with few or no publications (“blind spots”). One such area is the economics of BIM implementation. Considering the transition to the use of BIM as an investment project, the authors of the article formulate the necessary conditions for BIM implementation to become investment attractive. It is shown that the participation of governmental structures is necessary for a wide transition to digital technologies in the architectural and construction sphere

Nonalcoholic Fatty Liver Disease and the Risk of Atrial Fibrillation

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is now the factor behind the development of liver cirrhosis, liver cell failure, and liver transplantation in many cases. However, its relation to atrial fibrillation (AF) could not be cleared up. AIM: The purpose of the study was to evaluate prevalence of AF in the setting of NAFLD; the association between them, and to evaluate risk factors of AF in this category of patients. METHODS: This cross-sectional study was performed on 400 patients between January 2018 and June 2019. These patients were analyzed for the presence of NAFLD and presence of persistent or chronic AF. RESULTS: There were 138 patients with NAFLD, and 20 patients with persistent or permanent AF. Factors associated with AF were old age, male gender, and high values of aspartate aminotransferase, alanine-aminotransferase, γ-glutamyltranspeptidase, and serum uric acid. The participants with AF had a significantly greater prevalence of NAFLD than those without AF. CONCLUSION: Incidence and prevalence of atrial fibrillation in NAFLD patients were high. Severity of liver disease was an important predictor of new-onset atrial fibrillation

Skytider™

Skytider™ is a tool designed to facilitate the installation of buntings as compared to the existing method, which requires a ladder for climbing and the use of sizable manpower. Skytider™ applies an eco-friendly approach by replacing wires with cable ties. The use of wires during the usual way of bunting installation results in discarded wires that may rust the pole lights after the buntings are uninstalled from the pole. Skytider™ allows for installation without the need for individuals to climb and twist wires. Most importantly, it helps avoid the risk of an accident

Bacillus Calmette-Guérin-related cold thigh abscess as an unusual cause of thigh swelling in infants following BCG vaccine administration: a case series

<p>Abstract</p> <p>Introduction</p> <p>Thigh swelling in an infant can be a symptom of a simple benign condition or a life-threatening condition. We observed a cluster of thigh swelling episodes in infants in which the cause was Bacillus Calmette-Guérin-related cold thigh abscess. We report this unusual case series to raise awareness about this diagnosis.</p> <p>Case presentations</p> <p>We performed a retrospective review of five infants (four boys and one girl) who presented with Bacillus Calmette-Guérin-related left thigh abscess. The swelling was noticed by the parents at a mean period of three months prior to presentation. The ages at presentation were five, five, eight and nine months for the boys, and six months for the girl. All of the patients were healthy Saudi infants, and received the Bacillus Calmette-Guérin vaccine at birth. Clinically, all of the patients were well and did not demonstrate signs of systemic infection. All patients underwent needle aspiration, with subsequent incision and drainage in four of the five cases. The cultures obtained from the abscess fluids were the key to establishing the diagnosis. Only three patients (60%) received antituberculosis drugs. Wound healing lasted for a mean period of approximately seven months. Two-year follow-up was unremarkable for all of our patients.</p> <p>Conclusions</p> <p>Technical errors continue to be significant in the development of vaccine-related complications. Bacillus Calmette-Guérin-related cold thigh abscess is an extremely rare entity.</p

SkytiderTM mengatasi kesukaran memasang dan menurunkan gegantung outdoor (SkytiderTM - overcomes the difficultness of installing and lowering the outdoor bunting) / Asrizam Esam … [et al.]

Gegantung atau kain panji merupakan medium untuk mempromosikan iklan atau program yang banyak digunakan di Universiti Putra Malaysia setiap kali sesuatu program dijalankan. Terdapat dua jenis gegantung yang biasa digunakan iaitu gegantung indoor dan gegantung outdoor. Gegantung outdoor adalah gegantung yang dipasang di luar bangunan dan kebiasaannya digantung pada tiang lampu, pagar atau tempat penggantung khas yang dibina. Pemasangan gegantung outdoor kebiasaannya dipasang pada tiang lampu di sekitar UPM. Masalah yang sering dihadapi semasa memasang dan menurunkan gegantung outdoor pada tiang lampu adalah dari segi kaedah pemasangan dan penurunan, bilangan tenaga kerja yang ramai diperlukan, tempoh masa lama yang diperlukan dan tahap keselamatan pemasang yang berisiko ketika kerja pemasangan gegantung outdoor dijalankan. Kesukaran ini menyebabkan UPM menggunakan perkhidmatan kontraktor luar bagi kerja pemasangan setiap kali program dijalankan. Kesukaran ini juga turut dihadapi oleh universiti/institusi yang lain termasuk pihak syarikat kontraktor yang menjalankan kerja pemasangan gegantung outdoor. Masalah berjaya diatasi dengan beberapa inisiatif yang dikenalpasti iaitu melalui pelaksanaan Program Bebas Dawai, penambahbaikan panduan pemasangan gegantung (Bunting Standard Operating Procedure) di peringkat UPM dan penghasilan inovasi baharu SkytiderTM, iaitu alat yang dapat memudahkan proses pemasangan dan penurunan gegantung outdoor tanpa penggunaan tangga, mempercepatkan kerja pemasangan, meningkatkan tahap keselamatan pemasang dan seterusnya menjimatkan kos dengan mengurangkan kebergantungan penggunaan kontraktor luar. Hasil ciptaan alat SkytiderTM ini telah memperoleh perlindungan reka bentuk perindustrian, cap dagangan dan hakcipta. SkytiderTM telah diguna pakai di Kampus UPM Serdang Selangor, Bintulu Sarawak dan Port Dickson Negeri Sembilan

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