Study of vancomycin susceptibility pattern among Staphylococcus aureus isolated from superficial incisional surgical site infections

Background: Staphylococcus aureus (S. aureus), a well-known superbug, is the leading cause of surgical site infections (SSIs). High proportions of methicillin resistant S. aureus (MRSA) increased the use of vancomycin and this led to emergence of strains with reduced susceptibility to vancomycin. The present study aimed to study the pattern of vancomycin susceptibility among S. aureus isolates from cases of superficial incisional SSIs. Methods: Wound swabs, from 205 patients with superficial SSIs, were collected. S. aureus isolates were identified to the species level using conventional microbiological methods. Antimicrobial susceptibility testing was performed using modified Kirby-Bauer disc diffusion technique. Staphylococcus aureus susceptibility to vancomycin was assessed using E-test. Results: Out of 205 SSI cases, 73 (35.6%) were found to be caused by S. aureus representing the major causative organism followed by Klebsiella (23.9%), and E. coli (14.6%). Antimicrobial profile of S. aureus isolates revealed maximum sensitivity to tigecycline and linezolid.  Methicillin resistant S. aureus (MRSA) represented 68.5% of isolates. E-test showed that all S. aureus isolates were sensitive to vancomycin. Conclusions:  Staphylococcus aureus was the most common cause of SSIs and vancomycin still an effective treatment for MRSA. However, a higher degree of resistance to the commonly used antibiotics was observed, amplifying the need of strict adherence to rational antibiotic policy

Effect of Aromatase Inhibitors versus Clomiphene Citrate for Ovulation Induction in Infertile Women with Ovulatory Dysfunction (PCO)

A RCT conducted to assess the efficacy of letrozole as an ovulation induction agent in infertile women, and to compare the effectiveness of letrozole with the current standard agent, clomiphene citrate given for three successive cycles on the induction of ovulation. Forty-five infertile women with anovulation included, the subjects were randomly divided into two groups; subjects were allocated to either CC (100) or letrozole (5 mg) daily—5 days starting on the third day of menses, for 3 months. On stimulation day 12 subjects, serum estradiol and transvaginal sonography to document the number of follicles was done. On stimulation day 21 subjects, serum progesterone and ultrasound for the thickness of endometrium was done. Participants were followed-up monthly. Results revealed that the mean number of follicles reaching >18 mm and endometrial thickness in the letrozole comparable to those receiving clomiphene citrate. Letrozole showed lower estradiol level compared to Clomiphene citrate (P < 0.05). Ovulation occurred in 84.4%, 78.1% in the letrozole and clomiphene citrate, respectively, and pregnancy rate is 18.8% in the letrozole group compared to 15% in the clomiphene citrate group. In conclusion, there was no significant increase in the number of follicles, endometrial thickness and pregnancy rate induced by letrozole compared with clomiphene citrate

Utilidad clínica de la Tomografía computarizada cone beam para definir conducta terapéutica en casos de mediana y alta complejidad endodóntica.

Objectives: A systematic review was conducted to evaluate effectiveness and safety of beta carotenes for the treatment of oral leukoplakia regarding clinical resolution and prevention of malignant transformation. Material and Methods: The systematic search was conducted in three electronic databases and the study’s selection was performed according to pre-set eligibility criteria. Four studies evaluating the efficacy of beta carotenes in oral leukoplakia compared to placebo were included in the review; three of which were assigned for quantitative analysis. Data were extracted, tabulated, quality assessed and statistically analyzed. Results: The meta-analysis revealed that when comparing clinical resolution the beta carotene group favored was favored compared to placebo, with statistically significant difference. However, a meta-analysis comparing beta carotene and placebo groups regarding malignant transformation as a primary outcome failed to show any significant benefit. Furthermore, results showed evidence of beta carotene safety. Conclusion: the overall quality of evidence about efficacy of beta carotene in oral leukoplakia treatment was not high. However, given the obvious safety of this agent, data suggests it could have a promising effect in clinical improvement of oral leukoplakia lesions. However, no evidence supporting its benefits in reducing risk of malignant transformation in these lesions was found. Therefore, further long term, well designed randomized clinical trials are highly recommended.Objetivos: Se realizó una revisión sistemática para evaluar la efectividad y la seguridad de los betacarotenos para el tratamiento de la leucoplasia oral en relación con la resolución clínica y la prevención de la transformación maligna. Material y Métodos: la búsqueda sistemática se realizó en tres bases de datos electrónicas y la selección del estudio se realizó de acuerdo con los criterios de elegibilidad preestablecidos. En la revisión se incluyeron cuatro estudios que evaluaban la eficacia de los betacarotenos en la leucoplasia oral en comparación con el placebo; tres de los cuales fueron asignados para el análisis cuantitativo. Los datos fueron extraídos, tabulados, su calidad evaluada y analizados estadísticamente. Resultados: El metanálisis reveló que al comparar la resolución clínica, el grupo de betacaroteno fue favorecido en comparación con el placebo, con una diferencia estadísticamente significativa. Sin embargo, un metaanálisis que comparó los grupos de betacaroteno y placebo con respecto a la transformación maligna como resultado primario no mostró ningún beneficio significativo. Además, los resultados mostraron evidencia de seguridad de betacaroteno. Conclusión: La calidad general de la evidencia sobre la eficacia del betacaroteno en el tratamiento de la leucoplasia oral no es alta. Sin embargo, dada la obvia seguridad de este agente, los datos sugieren que podría tener un efecto prometedor en la mejora clínica de las lesiones de leucoplasia oral. Sin embargo, no se encontraron pruebas que respalden sus beneficios en la reducción del riesgo de transformación maligna en estas lesiones. Por lo tanto, se recomiendan ensayos clínicos aleatorios bien diseñados a largo plazo

Effect of Balcony’s Design Parameters on Energy Performance of Residential Buildings

Residential buildings have a critical role in energy consumption, contributing to produce greenhouse gases and creating urban heat island. For this reason, optimizing the building energy usage is avital issue. Balconies can be considered one of the building façade elements that have considerable thermal performance. The main aim of the paper is to assess the contribution of various balcony design parameters on indoor thermal performance and energy consumption of residential buildings.A simulation study was conducted for a residential villa located in hot climate country, Cairo Egypt. Different design parameters were investigated and 6 case studies were compared in order to study the effect of each one on building’s thermal performance. Results show that southwest oriented balcony with wall insulation material and using double clear glazing for window are the most effective parameters on cooling loads of the studied bedroom space in residential villa located in hot climate of Cairo, therefore affecting building energy consumption.Finally, the research highlights the effect of various balcony design parameters on building thermal performance in order to reduce energy consumption in residential buildings

Prevalence of Poliovirus Specific Salivary IgA and Serum IgG in Orally Poliovirus Immunized Preschool Children

This study was conducted in Omdurman municipality hospitals during the period of February 2007 to February 2008 to study the prevalence of poliomyelitis virus antibodies in the saliva and sera of OPV immunized preschool-aged children using an in-house ELISA. Data concerning history of immunization, other medical information and demographic data that collected using structural questionnaire with informedconsent of the mother or gardian of each participant child. One hundred children of 1year to more than 4 years were included. Blood and saliva were collected from each child.Positive control saliva and sera were obtained from multiple OPV immunized children, whereas negative control saliva and sera were obtained from non-OPV immunized children and tested in pilot ELISA study. OPV was heat inactivated and used as a solid phase antigen for coating the ELISA plates. Goat αFc human IgA and IgG conjugated to (Horse radish peroxidase) HPO were used for the detection of salivary IgA and serum IgG respectively. From ELISA pilot studies we elaborated an in-house ELISA to study the prevalence of (poliovirus) PV specific SIgA and IgG in saliva and seraof OPV immunized children. Several factors that could affect IgA, IgG, and IgA/IgG ratio were investigated in this study such as age, sex, and area of residence. In this study the prevalence of polio virus specific salivary IgA and serum IgG were detected in the various age groups of OPV immunized children. The absorbance values of polio virus specific salivary IgA and serum IgG were very high in all age groups. However, the differences between these values among all age groups were not statistically significant. The Pvalue for IgA was (0.36) and for IgG the Pvalue was (0.20). Furthermore, children who received two or five doses of OPV had the same absorbance values for IgA and IgG. Moreover, salivary IgA /serum IgG absorbance valuesratio in all age groups were also non-statistically significant (P= 0.45). These results clearly demonstrated that iv OPV induced both local and systemic Abs responses in all immunized children. Moreover, the prevalence of polio virus specific salivary IgA and serum IgG was the same in both sex. Absorbance values for PV specific salivary IgA was relatively high in comparison with PV specific IgG in both sex, but these differences were not statistically significant (P= 0.294 for IgA and P= 0.255 for IgG) for both isotypes. However, significantly higher salivary IgA/serum IgG absorbance ratio were found in males than in females (P= 0.03). OPV immunized children from various area of residences had high prevalence PV specific salivary IgA and serum IgG. However, the absorbance values of salivary IgA were relatively higher in comparison with polio virus specific serum IgG. However, these absorbance differences were not statistically significant among children of various area of residences for both isotypes (P= 0.383 for IgA and P= 0.276 for IgG), salivary IgA/ serum IgG absorbance ratio were statistically not significant as well (P= 0.058). A linear relationship between salivary IgA and serum IgG was found and OPV immunization armament children with local and systemic Abs responses that make it difficult for wild virus to escape any of the two lines of defense. In this study we concluded that OPV immunization in childhood produces both local and systemic Abs response. The number of doses of OPV, age, sex and area of residence had no significant effect (P>0.05) on the value of salivary IgA and IgG, whereas sex had a significant effect on the salivary IgA/ serum IgG ratio. Our in-house ELISA is a useful tool for monitoring OPV immunization campaigns for the eradication of poliomyeliti

Experimental Results Help Shape the Development of Personalized Medicine in Colorectal Cancer

With estimated 700,000 deaths each year, colorectal carcinoma (CRC) continues to be the fourth leading cause of cancer-related deaths worldwide. Fortunately, the mortality of CRC is considered to be most avertable; hence, it is essential to develop new approaches for more accurate and early diagnosis of primary as well as metastatic CRC, including genetic and biomarker tests. In this regard, the intercellular junctions and the insulin-like growth factor (IGF) axis attract increasing attention, since they are involved in several stages of cancer and for their vital role in regulating cell survival and growth; furthermore, constituents of intercellular junctions and of the IGF axis could be used as tumor and/or metastasis markers, which are becoming the focus of increasing research activities. Our experimental results highlight the importance of gene expression changes in the tight junction proteins claudins, and in the IGF-binding proteins IGFBP3 and IGFBP7. They show additionally that claudins and IGFBPs cannot be simply defined in terms of favoring or antagonizing cancer progression but have additional properties and activities, which become apparent only in the context of liver colonization. Furthermore, their intensive modulation during the initial phase of liver colonization may suggest them as early metastasis-related markers

Smartphone-based Thermal Imaging System for Diabetic Foot Ulcer Assessment

International audienceThis research work is part of the STANDUP project http://www.standupproject.eu/ dedicated to improve diabetic foot ulcer prevention and treatment of the plantar foot surface using smartphone-embedded thermal imaging system. The aim of this preliminary work is to build an ulcer assessment tool based on a smartphone and an IR thermal camera. The proposed system represents a practical tool for accurate DFU healing assessment, combining color and thermal information in a single user-friendly system. To ensure robust tissue identification, an annotation software was developed based on SLIC superpixel segmentation algorithm. The tool thus developed allows clinicians to achieve objective and accurate tissue identification and annotation. The proposed system could serve as an intelligent telemedicine system to be deployed by clinicians at hospitals and healthcare centers for more accurate diagnosis of diabetic foot ulcers

Les croyances des enseignants et des apprenants adultes quant à la rétroaction corrective à l’oral et la pratique réelle en classe de français langue étrangère en Égypte

Différentes études ont montré que le niveau des futurs enseignants, issus des écoles publiques, en français langue étrangère (FLE) en Égypte est assez faible. Ceux-ci font un grand nombre d’erreurs répétitives à l’oral. Quoique ce manque de précision langagière puisse être dû à plusieurs facteurs, il appert que la rétroaction soit une des variables contribuant à ce phénomène (comme le nombre d’étudiants en classe, la durée du cours, l’âge et la motivation des étudiants, les méthodes d’enseignement, etc.). La rétroaction corrective est généralement définie comme toute correction explicite ou implicite de la part de l’enseignant indiquant que la production de l’apprenant est erronée. Elle est considérée comme indispensable dans les classes de langues secondes (LS) (Shmidt, 1983, 2001 ; Long, 1991, 1996 ; Lightbown, 1998). Pour ces raisons, cette étude porte sur la rétroaction corrective et, plus spécifiquement, sur les croyances des enseignants et des apprenants quant à celle-ci, ainsi qu’à son utilisation dans les classes de FLE en Égypte. Les recherches antérieures indiquent que les croyances des enseignants quant à l’acte d’enseigner influencent leurs pratiques en classe, que les croyances des apprenants influencent leur motivation, leur niveau et leurs efforts déployés pour l’apprentissage de la langue, et qu’une divergence entre les croyances des professeurs et celles des apprenants peut entraîner des effets négatifs sur l’apprentissage de la langue cible, ce qui indique ainsi qu’il est de grande importance d’explorer les croyances. Ainsi, la présente étude vise à explorer les croyances des professeurs égyptiens et celles de leurs étudiants en ce qui a trait à la rétroaction corrective à l’oral, la différence entre ces croyances, et l’identification des pratiques réelles des professeurs afin de décrire à quel point celles-ci reflètent les croyances exprimées. Pour ce faire, un questionnaire a été administré à 175 étudiants et 25 professeurs appartenant à trois universités égyptiennes afin de déterminer leurs croyances déclarées. Des entrevues semi-dirigées et des observations directes ont été réalisées auprès de neuf des 25 professeurs participants pour mieux déterminer leurs croyances et leurs pratiques rétroactives. Les résultats obtenus ont révélé qu’il existe des divergences importantes entre les croyances des professeurs et celles des étudiants, d’un côté, et entre les croyances des professeurs et leur pratique, de l’autre côté. Par exemple, la plupart des étudiants ont déclaré leur opposition à l’utilisation de la reformulation alors que presque la moitié des professeurs ont indiqué être en faveur de cette même technique. Les professeurs ont indiqué que leur choix de techniques rétroactives dépend du type d’erreurs et qu’ils préfèrent inciter les apprenants à s’auto corriger. Cependant, ces mêmes professeurs ont utilisé la reformulation pour corriger la majorité des erreurs de leurs apprenants, quelle que soit leur nature. Nous parvenons ainsi à la conclusion que l’utilisation de la reformulation, qui fait l’objet d’une divergence au niveau des croyances, pourrait être à l’origine du manque de précision langagière rapporté par les chercheurs.Previous research revealed that Egyptian learners of French as a foreign language who will be the future teachers of French in Egypt produce numerous errors repetitively during oral productions. While this lack of accuracy can be attributed to a cohort of factors (number of students in class, duration of course, age and motivation of students, methods of teaching, etc.), it is assumed in the present study that corrective feedback could be at the origins of the reported results. Defined as implicit or explicit teacher reactions to the learners’ incorrect renditions, corrective feedback is seen by many second language acquisition researchers (Schmidt, 1983, 2001; Long, 1991, 1996; Lightbown, 1998) as a driving force behind interlanguage development. Among other things, corrective feedback draws learners’ attention to form and helps them notice the gap between their interlanguage and the L2 norm. In light of these theoretical arguments along with empirical research findings indicating the benefits of corrective feedback, the present study investigated corrective feedback provided in French as a foreign language classes in Egyptian universities. More specifically, the study explored teachers’ and students’ beliefs about feedback as well as teachers’ in-class use of feedback. Previous research on beliefs indicates that teachers’ beliefs shape their teaching and that learners’ beliefs affect their motivation and determine the effort students are willing to deploy to learn the target language. Based on these theoretical and empirical claims, the present study investigated teachers’ and students’ beliefs about oral corrective feedback in learning French as a foreign language in Egypt and explored teachers’ actual corrective feedback practices to determine the extent to which they correspond to their declared beliefs. A beliefs questionnaire was administered to 175 students and 25 language teachers to determine their beliefs about corrective feedback. Nine of the 25 teachers were also interviewed and observed for a total of 27 hours to further investigate their beliefs and in-class practices. The results indicate a mismatch between teachers’ and students’ beliefs on the one hand, and a divergence between teachers’ beliefs and their actual teaching on the other. In terms of the relationship between students’ and teachers’ beliefs, the results reveal that while the majority of the learners do not see recasts as an effective feedback technique, almost half of the teachers do. As for the mismatch between teachers’ beliefs and their in-class practices, a two-fold pattern emerged. First, all the teachers reported that error type determined the technique they used to correct errors and that they preferred to push their learners to self-correct. However, recasts proved to be the technique of choice and that was regardless of error type. Instances of self-correction were rare with teachers choosing to recast most of their students’ errors instead of pushing them to remedy the errors on their own. As such, it may be speculated that the teachers’ choice of corrective feedback techniques, which happens to run counter to the students’ expectations (as shown in the beliefs questionnaire) may be a major factor behind the students’ reported lack of accurac