How Does The Fasting of Ramadan Affect Breast Milk Constituents?

Background: Breast-feeding of infants is associated with their better biological, psychological and intellectual development. However, many factors affect the volume and composition of human milk such as stage of lactation and maternal diet. Many breast-feeding Muslim mothers fast the lunar month of Ramadan. The effects of fasting on milk constituents have not been previously studied in Sudan. Therefore, we aimed to investigate the variations between milk constituents during fasting and non-fasting periods among a group of Sudanese women.Materials and Methods: Twenty four healthy breast-feeding mothers volunteered to participate in this cross-sectional study. Each mother provided 100 ml of breast milk during fasting and again 2 weeks after end of the fasting month of Ramadan. Milk was properly stored and analyzed for the various constituents, using the appropriate laboratory methods. The main constituents analyzed were: ash, protein, lactose, iron and electrolytes.Results: The age range of lactating women was between 18 and 38 years, mean (+SD) 28.8 (± 5.15 years). Most mothers 17 (70.8%) were house-wives. Analysis of breast milk during fasting and non-fasting periods showed that: lactose, protein, sodium, potassium, calcium and phosphate were significantly decreased in the fasting breast milk compared with the non-fasting milk (p=0.01), while total soluble solid, moisture, ash and iron constituents had not significantly changed during fasting.Conclusion: Fasting of Ramdan significantly affects proteins, carbohydrates and electrolytes in breast milk.Keywords: breast-feeding, milk constituents, Ramadan, fasting

Trends in the assessment of multidrug efficiency against identified bacterial strains isolated from wounds at El-Demerdash Hospital, Egypt

Multidrug-resistant (MDR) bacteria is a severe problem for universal public health which increases morbidity and mortality rate. These resistant bacteria lead to ineffective treatment of drugs resulting in the spreading and persistence of infections. So, the major target of this study is to estimate the competence of multidrug antibacterial agents against bacterial strains isolated from wound samples and then identify the most potent Multidrug-resistant (MDR) bacteria. Fifty wound swab specimens were gathered from various wounds and several patients from the Central Microbiology Laboratory of El-Demerdash Hospital, Cairo, Egypt. Eighty- nine bacterial isolates were isolated from fifty wound samples then cultured on different media and tested for their susceptibility to different thirty antibiotic discs using the agar disc diffusion method. After recording the results of the susceptibility test, the post potent resistant bacterial isolates recorded 3 bacterial isolates which resistant to 30 different antibiotic types. These resistant bacterial isolates were identified using morphological, biochemical, and molecular techniques. The results recorded that the post potent resistant bacterial isolates identified as Klebsiella oxytoca, Pseudomonas aeruginosa, and Escherichia coli. This study concluded that with the increase in the random use of antibiotic drugs resulted in the presence of multi-antibacterial resistant strains. There are bacterial strains that were isolated from wounds in patients at El-Demerdash Hospital, Egypt, and identified. They can resist about thirty different antibiotic discs. Abbreviation: Multiple antibiotic resistance (MAR)

Prognostic impact of lipid profile in adult Egyptian acute leukemia patients

Introduction: Acute leukemia is a malignant disorder which results from clonal proliferation of lymphoid and myeloid blast cells. Several studies have reported changes in lipid metabolism at the time of diagnosis of leukemia. Although investigators have reported decreased total cholesterol, decreased high-density lipoprotein, and elevated triglyceride (TG) in leukemic patients, there is a lack of agreement about these changes among different types of leukemia and between children and adult patients, in addition to different data about their impacts on prognosis. In this study, lipid profile has been examined at the time of diagnosis of acute leukemia in order to correlate it with response to therapy. Material and methods: This is a prospective study carried out at the Oncology Center at Mansoura University, Egypt between 2018 and 2019. Fifty patients newly diagnosed with de novo acute leukemia were included. Thirty-four patients were diagnosed with acute myeloid leukemia (AML) (68%), while 16 patients were diagnosed with acute lymphoblastic leukemia (ALL) (32%). Lipid profile and body mass index (BMI) data was obtained. Results: Overweight/obese patients showed a more statistically significant association with female patients than with male patients (p = 0.009). By comparing the lipid profile between overweight/obese patients and other patients, there was no statistically significant association. 76.7% of AML patients were overweight or obese (p = 0.015), and 81.3% of ALL patients showed hypertriglyceridemia (p = 0.014). There was no statistically significant association between lipid profile and complete response (CR) rate; however, there was a marginally significant association between non-CR rate and overweight and obese patients (p = 0.051). In addition, there was no impact of BMI or lipid profile on overall survival among acute leukemia patients. Conclusions: Female, and acute myeloid leukemia, patients were more commonly associated with overweight and obesity, and high TG level was found to be associated with acute lymphoid leukemia. Changes in lipid profile showed no impact on complete response rate or on overall survival in acute leukemia patients

Physical activity level and stroke risk in US population: A matched case-control study of 102,578 individuals

Background: Stroke has been linked to a lack of physical activity; however, the extent of the association between inactive lifestyles and stroke risk has yet to be characterized across large populations. Purpose: This study aimed to explore the association between activity-related behaviors and stroke incidence. Methods: Data from 1999 to 2018 waves of the concurrent cross-sectional National Health and Nutrition Examination Survey (NHANES) were extracted. We analyzed participants characteristics and outcomes for all participants with data on whether they had a stroke or not and assessed how different forms of physical activity affect the incidence of disease. Results: Of the 102,578 individuals included, 3851 had a history of stroke. A range of activity-related behaviors was protective against stroke, including engaging in moderate-intensity work over the last 30 days (OR = 0.8, 95% CI = 0.7-0.9; P = 0.001) and vigorous-intensity work activities over the last 30 days (OR = 0.6, 95% CI = 0.5-0.8; P \u3c 0.001), and muscle-strengthening exercises (OR = 0.6, 95% CI = 0.5-0.8; P \u3c 0.001). Conversely, more than 4 h of daily TV, video, or computer use was positively associated with the likelihood of stroke (OR = 11.7, 95% CI = 2.1-219.2; P = 0.022). Conclusion: Different types, frequencies, and intensities of physical activity were associated with reduced stroke incidence, implying that there is an option for everyone. Daily or every other day activities are more critical in reducing stroke than reducing sedentary behavior duration

LOCUS OF CONTROL THEORY IN TREATING TOURIST BEHAVIOR: THE THEORY ROOTS AND RESEARCH DIRECTION IN DESTINATION BRANDING FIELD

We aim to shed light on this issue by reviewing the roots and development of the locus of control theory. Moreover, we will introduce how we can use this development, in theory, to provide a new research direction in the tourism service field. A theory-based review was conducted to investigate the locus of control theory roots and its potential implications in the tourism industry using the Australian Business Deans Council (ABDC) list to explore the current literature. We followed the PRISMA methodology to collect the data from the Scopus database as well as Google Scholar and ResearchGate. The study found that the locus of control theory has its roots in social psychology and has been developed over the years to explain individual differences in behavior and decision-making. In the tourism service field, we found that understanding the locus of control can help service providers tailor their services to meet the needs and expectations of different types of tourists. This will contribute to attribution literature in psychological aspects and tourism literature with a deep understanding of how tourists behave and interpret differently

Transcriptional analysis of Rhazya stricta in response to jasmonic acid

Background: Jasmonic acid (JA) is a signal transducer molecule that plays an important role in plant development and stress response; it can also efficiently stimulate secondary metabolism in plant cells. Results: RNA-Seq technology was applied to identify differentially expressed genes and study the time course of gene expression in Rhazya stricta in response to JA. Of more than 288 million total reads, approximately 27% were mapped to genes in the reference genome. Genes involved during the secondary metabolite pathways were up- or downregulated when treated with JA in R. stricta. Functional annotation and pathway analysis of all up- and downregulated genes identified many biological processes and molecular functions. Jasmonic acid biosynthetic, cell wall organization, and chlorophyll metabolic processes were upregulated at days 2, 6, and 12, respectively. Similarly, the molecular functions of calcium-transporting ATPase activity, ADP binding, and protein kinase activity were also upregulated at days 2, 6, and 12, respectively. Time-dependent transcriptional gene expression analysis showed that JA can induce signaling in the phenylpropanoid and aromatic acid pathways. These pathways are responsible for the production of secondary metabolites, which are essential for the development and environmental defense mechanism of R. stricta during stress conditions. Conclusions: Our results suggested that genes involved in flavonoid biosynthesis and aromatic acid synthesis pathways were upregulated during JA stress. However, monoterpenoid indole alkaloid (MIA) was unaffected by JA treatment. Hence, we can postulate that JA plays an important role in R. stricta during plant development and environmental stress conditions. How to cite: Hajrah, NH, Rabah SO, Alghamdi MK, et al. Transcriptional analysis of Rhazya stricta in response to jasmonic acid. Electron J Biotechnol 2021;50. https://doi.org/10.1016/j.ejbt.2021.01.00

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

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020