Non-Steroidal Anti-Inflammatory Drugs and Antibiotics Prescription Trends at a Central West Bank Hospital

Objectives: We aimed to reliably describe the pattern of outpatient prescription of non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics (ATBs) at a central hospital in the West Bank, Palestine.Methods: This was a retrospective, cross-sectional study investigating a cohort of 2,208 prescriptions ordered by outpatient clinics and the emergency room over one year in Beit Jala Hospital in Bethlehem, West Bank. The orders were analysed for the rate and types of NSAIDs and ATBs utilised, and the appropriateness of these drugs to the diagnosis. Results: Of the total prescriptions, 410 contained NSAIDs (18.6%), including diclofenac (40.2%), low dose aspirin (23.9%), ibuprofen (17.8%) and indomethacin (15.1%). A minority of these prescriptions contained a combination of these agents (2.5%). Only one prescription contained cyclooxyeganse-2 inhibitors (0.2%). The appropriateness of NSAID use to the diagnosis was as follows: appropriate (58.3%), inappropriate (14.4%) and difficult to tell (27.3%). The rate of ATB use was 30.3% (669 prescriptions). The ATBs prescribed were amoxicillin (23.3%), augmentin (14.3%), quinolones (12.7%), first and second generation cephalosporins (9.4% and 12.7%, respectively) and macrolides (7.2%). ATB combinations were identified in 9.4%, with the most common being second-generation cephalopsorins and metronidazole (4.3%). Regarding the appropriateness of prescribing ATBs according to the diagnosis, it was appropriate in 44.8%, inappropriate in 20.6% and difficult to tell in 34.6% of the prescriptions. Conclusion: These findings revealed a relatively large number and inappropriate utilisation of ATBs and NSAIDs. An interventional programme needs to be adopted to reinforce physicians’ knowledge of the rational prescription of these agents

Comparative Analysis of Rankine Cycle Linear Fresnel Reflector and Solar Tower Plant Technologies: Techno-Economic Analysis for Ethiopia

The need to meet the world’s growing demand for energy in an environmentally sustainable manner has led to the exploration of various renewable energy (RE) resources for power gen-eration. The objective of this study is to examine the techno-economic potential of concentrated solar power plants (i.e., linear Fresnel reflector (LFR) and central receiver system (CRS) for electricity generation in Eastern African countries with a case study on Ethiopia. The study was conducted using the System Advisor Model (SAM). In order to estimate the economics of the two power plants, the Levelized cost of energy (LCOE) and the net present value (NPV) metrics were used. According to results obtained from the simulations, the LFR produced annual energy of 528 TWh at a capacity factor (CF) of 60.3%. The CRS also produced a total of 540 TWh at a CF of 61.9%. The LCOE (real) for the CRS is found to be 9.44 cent/kWh against 10.35 cent/kWh for the LFR. The NPV for both technologies is found to be positive for inflation rates of 2% and below. An inflation rate above 2% renders the two power plants financially impracticable. A real discount rate above 9% also renders both projects economically unviable. Based on the obtained results, the CRS system is identified as the best technology for electricity generation under the Jijiga climatic condition in Ethiopia. © 2022 by the authors. Li-censee MDPI, Basel, Switzerland.Taif University Researchers Supporting Project Number (TURSP-2020/61), Taif University, Taif, Saudi Arabia

Clinical Prediction of Blood Parameters Associated with Breast, Colon, Thyroid, Ovarian, and Prostate Cancer

Cancer is a cellular change caused by uncontrolled cell growth and division. This disease develops from the growth of abnormal cells that have the potential to invade or spread to other parts of the body. The aim of this study was to investigate the relationship between blood parameters (e.g., Mean corpuscular volume (MCV), Mean corpuscular hemoglobin (MCH), Mean Corpuscular Hemoglobin Concentration (MCHC), Haemoglobin (HGB), White Blood Cell (WBC), and Red Blood Cell (RBC)) and different types of cancer. Breast cancer, thyroid gland cancer, ovarian cancer, testicular cancer, brain tumors as well as other types of cancer are based on the cell of the tissue found on or in the body. Any of these types of cancer are associated with a variety of health issues that put the patient's life in danger. Performing the complete blood count (CBC) test prior to or after a cancer diagnosis is necessary as abnormalities in the body can cause blood component rates to either increase or decrease, depending on the type of cancer, the patient's physiological mechanism, and the structural component. Since the CBC test belongs to hematology, drawing a blood sample and putting it into the anticoagulant tube for testing were preferred. In this study, the blood components of almost all patients were normal except for a few of them which may be due to other medical and biological factors. There is a significant relationship between blood parameters and cancer types.&nbsp

Multidrug-resistant and clonal dispersion of enterotoxigenic Escherichia coli from ready-to-eat meat products in Duhok province, Iraq

This research evaluated the effluent proportion of E. coli and ETEC in RTE meat products, characterized the isolated strains' clonal relatedness, and determined their antibiotic resistance. 130 RTE products were gathered from various restaurants and street fast food vendors in Duhok and Zakho Province. The Isolates of E. coli identified by culture methods were confirmed as ETEC by multiplex PCR of the identified virulence genes. ERIC-PCR was applied to establish the clonal relationships between strains. The disk diffusion method performed the susceptibility of antibiotics on the isolated ETEC. Out of 130 examined samples, 39 (30%) isolates of E. coli and 16 (12.3%) ETEC were detected. Pan-fried burgers were revealed to be the most frequent contaminated sample type, with both E. coli and ETEC 50% and 23.3%, respectively (P≤0.05). A high clonal dispersion (12 genotypes) was observed among the isolated ETEC strains. A strong genetic linkage was discovered between a few isolates retrieved from the same sample type and within the strains from the same geographic source area. A high antibiotic resistance rate was observed with total resistance to Amoxicillin/clavulanate, Clarithromycin, Doxycycline, Erythromycin, and Clindamycin. Isolates from burger samples showed a higher resistance rate when compared with the other sample types (P≤0.05). Multi-drug resistance was noticed in all ETEC isolates. RTE meat products sold in our area have a high rate of clonally heterogeneous carrying multi-drug resistant ETEC and may constitute a significant public health risk

ABO blood group system and placental malaria in an area of unstable malaria transmission in eastern Sudan

<p>Abstract</p> <p>Background</p> <p>Understanding the pathogenesis of malaria in pregnancy and its consequences for both the mother and the baby is fundamental for improving malaria control in pregnant women.</p> <p>Aim</p> <p>The study aimed to investigate the role of ABO blood groups on pregnancy outcomes in an area of unstable malaria transmission in eastern Sudan.</p> <p>Methods</p> <p>A total of 293 women delivering in New Half teaching hospital, eastern Sudan during the period October 2006–March 2007 have been analyzed. ABO blood groups were determined and placental histopathology examinations for malaria were performed. Birth and placental weight were recorded and maternal haemoglobin was measured.</p> <p>Results</p> <p>114 (39.7%), 61 (22.1%) and 118 (38.2%) women were primiparae, secundiparae and multiparae, respectively. The ABO blood group distribution was 82(A), 59 (B), 24 (AB) and 128 (O). Placental histopathology showed acute placental malaria infections in 6 (2%), chronic infections in 6 (2%), 82 (28.0%) of the placentae showed past infection and 199 (68.0%) showed no infection. There was no association between the age (OR = 1.02, 95% CI = 0.45–2.2; <it>P </it>= 0.9), parity (OR = 0.6, 95% CI = 0.3–1.2; <it>P </it>= 0.1) and placental malaria infections. In all parity blood group O was associated with a higher risk of past (OR = 1.9, 95% CI = 1.1–3.2; <it>P </it>= 0.01) placental malaria infection. This was also true when primiparae were considered separately (OR = 2.6, 95% CI = 1.05–6.5, <it>P </it>= 0.03).</p> <p>Among women with all placental infections/past placental infection, the mean haemoglobin was higher in women with the blood group O, but the mean birth weight, foeto-placental weight ratio was not different between these groups and the non-O group.</p> <p>Conclusion</p> <p>These results indicate that women of eastern Sudan are at risk for placental malaria infection irrespective to their age or parity. Those women with blood group O were at higher risk of past placental malaria infection.</p

BRAVE-NET: Fully Automated Arterial Brain Vessel Segmentation in Patients With Cerebrovascular Disease

Introduction: Arterial brain vessel assessment is crucial for the diagnostic process in patients with cerebrovascular disease. Non-invasive neuroimaging techniques, such as time-of-flight (TOF) magnetic resonance angiography (MRA) imaging are applied in the clinical routine to depict arteries. They are, however, only visually assessed. Fully automated vessel segmentation integrated into the clinical routine could facilitate the time-critical diagnosis of vessel abnormalities and might facilitate the identification of valuable biomarkers for cerebrovascular events. In the present work, we developed and validated a new deep learning model for vessel segmentation, coined BRAVE-NET, on a large aggregated dataset of patients with cerebrovascular diseases. Methods: BRAVE-NET is a multiscale 3-D convolutional neural network (CNN) model developed on a dataset of 264 patients from three different studies enrolling patients with cerebrovascular diseases. A context path, dually capturing high- and low-resolution volumes, and deep supervision were implemented. The BRAVE-NET model was compared to a baseline Unet model and variants with only context paths and deep supervision, respectively. The models were developed and validated using high-quality manual labels as ground truth. Next to precision and recall, the performance was assessed quantitatively by Dice coefficient (DSC); average Hausdorff distance (AVD); 95-percentile Hausdorff distance (95HD); and via visual qualitative rating. Results: The BRAVE-NET performance surpassed the other models for arterial brain vessel segmentation with a DSC = 0.931, AVD = 0.165, and 95HD = 29.153. The BRAVE-NET model was also the most resistant toward false labelings as revealed by the visual analysis. The performance improvement is primarily attributed to the integration Hilbert et al. Fully-Automated Arterial Brain Vessel Segmentation of the multiscaling context path into the 3-D Unet and to a lesser extent to the deep supervision architectural component. Discussion: We present a new state-of-the-art of arterial brain vessel segmentation tailored to cerebrovascular pathology. We provide an extensive experimental validation of the model using a large aggregated dataset encompassing a large variability of cerebrovascular disease and an external set of healthy volunteers. The framework provides the technological foundation for improving the clinical workflow and can serve as a biomarker extraction tool in cerebrovascular diseases

Meningitis Dipstick Rapid Test: Evaluating Diagnostic Performance during an Urban Neisseria meningitidis Serogroup A Outbreak, Burkina Faso, 2007

Meningococcal meningitis outbreaks occur every year during the dry season in the “meningitis belt” of sub-Saharan Africa. Identification of the causative strain is crucial before launching mass vaccination campaigns, to assure use of the correct vaccine. Rapid agglutination (latex) tests are most commonly available in district-level laboratories at the beginning of the epidemic season; limitations include a short shelf-life and the need for refrigeration and good technical skills. Recently, a new dipstick rapid diagnostic test (RDT) was developed to identify and differentiate disease caused by meningococcal serogroups A, W135, C and Y. We evaluated the diagnostic performance of this dipstick RDT during an urban outbreak of meningitis caused by N. meningitidis serogroup A in Ouagadougou, Burkina Faso; first against an in-country reference standard of culture and/or multiplex PCR; and second against culture and/or a highly sensitive nested PCR technique performed in Oslo, Norway. We included 267 patients with suspected acute bacterial meningitis. Using the in-country reference standard, 50 samples (19%) were positive. Dipstick RDT sensitivity (N = 265) was 70% (95%CI 55–82) and specificity 97% (95%CI 93–99). Using culture and/or nested PCR, 126/259 (49%) samples were positive; dipstick RDT sensitivity (N = 257) was 32% (95%CI 24–41), and specificity was 99% (95%CI 95–100). We found dipstick RDT sensitivity lower than values reported from (i) assessments under ideal laboratory conditions (>90%), and (ii) a prior field evaluation in Niger [89% (95%CI 80–95)]. Specificity, however, was similar to (i), and higher than (ii) [62% (95%CI 48–75)]. At this stage in development, therefore, other tests (e.g., latex) might be preferred for use in peripheral health centres. We highlight the value of field evaluations for new diagnostic tests, and note relatively low sensitivity of a reference standard using multiplex vs. nested PCR. Although the former is the current standard for bacterial meningitis surveillance in the meningitis belt, nested PCR performed in a certified laboratory should be used as an absolute reference when evaluating new diagnostic tests

Risk stratification and subclinical phenotyping of dilated and/or arrhythmogenic cardiomyopathy mutation-positive relatives:CVON eDETECT consortium

In relatives of index patients with dilated cardiomyopathy and arrhythmogenic cardiomyopathy, early detection of disease onset is essential to prevent sudden cardiac death and facilitate early treatment of heart failure. However, the optimal screening interval and combination of diagnostic techniques are unknown. The clinical course of disease in index patients and their relatives is variable due to incomplete and age-dependent penetrance. Several biomarkers, electrocardiographic and imaging (echocardiographic deformation imaging and cardiac magnetic resonance imaging) techniques are promising non-invasive methods for detection of subclinical cardiomyopathy. However, these techniques need optimisation and integration into clinical practice. Furthermore, determining the optimal interval and intensity of cascade screening may require a personalised approach. To address this, the CVON-eDETECT (early detection of disease in cardiomyopathy mutation carriers) consortium aims to integrate electronic health record data from long-term follow-up, diagnostic data sets, tissue and plasma samples in a multidisciplinary biobank environment to provide personalised risk stratification for heart failure and sudden cardiac death. Adequate risk stratification may lead to personalised screening, treatment and optimal timing of implantable cardioverter defibrillator implantation. In this article, we describe non-invasive diagnostic techniques used for detection of subclinical disease in relatives of index patients with dilated cardiomyopathy and arrhythmogenic cardiomyopathy