Severe cytomegalovirus gastritis during natalizumab-mediated immunosuppression

We report a 35-year-old female receiving natalizumab as monotherapy for multiple sclerosis who subsequently developed severe cytomegalovirus gastritis. As cytomegalovirus gastritis has not been previously described during natalizumab treatment, we discuss the biological plausibility of this potential association and avenues for further study

Replication and availability in decentralised online social networks

A thesis submitted to the University of Bedfordshire in partial fulfilment of the requirements for the degree of Master of PhilosophyDuring the last few years’ online social networks (OSNs) have become increasingly popular among all age groups and professions but this has raised a number of issues around users’ privacy and security. To address these issues a number of attempts have been made in the literature to create the next generation of OSNs built on decentralised architectures. Maintaining high data availability in decentralised OSNs is a challenging task as users themselves are responsible for keeping their profiles available either by staying online for longer periods of time or by choosing trusted peers that can keep their data available on their behalf. The major findings of this research include algorithmically determining the users’ availability and the minimum number of replicas required to achieve the same availability as all mirror nodes combined. The thesis also investigates how the users’ availability, replication degree and the update propagation delay changes as we alter the number of mirror nodes their online patterns, number of sessions and session duration. We found as we increase the number of mirror nodes the availability increases and becomes stable after a certain point which may vary from node to node as it directly depends on the node’s number of mirror nodes and their online patterns. Moreover, we also found the minimum number of replicas required to achieve the same availability as all mirror nodes combined and update propagation delay directly depends on mirror nodes’ number of sessions and session duration. Furthermore, we also found as we increase the number of sessions with reduced session lengths the update propagation delay between the mirror nodes starts to decrease. Thus resulting in spreading the updates faster as compared to mirror nodes with fewer sessions but of longer durations

Superstring Theory on pp Waves with ADE Geometries

We study the BMN correspondence between certain Penrose limits of type IIB superstrings on pp-wave orbifolds with $ADE$ geometries, and the set of four-dimensional $\mathcal{N}=2$ superconformal field theories constructed as quiver gauge models classified by finite $ADE$ Lie algebras and affine $\hat{ADE}$ Kac-Moody algebras. These models have 16 preserved supercharges and are based on systems of D3-branes and wrapped D5- and D7-branes. We derive explicitly the metrics of these pp-wave orbifolds and show that the BMN extension requires, in addition to D5-D5 open strings in bi-fundamental representations, D5-D7 open strings involving orientifolds with $Sp(N)$ gauge symmetry. We also give the correspondence rule between leading string states and gauge-invariant operators in the $\mathcal{N}=2$ quiver gauge models.Comment: 62 page

Evaluation of the Surgical and Pharmacological Treatment of Diabetic Foot Infection: A Retrospective Study

BACKGROUND: Diabetic foot infection is a major cause of patient disabilities and lowers limb amputations, with high treatment costs and hospitalisation requirements. AIM: Aim of this study was to evaluate surgical wound care plus antibiotic effects in the treatment of mild and moderate diabetic foot infections. METHODS: This retrospective study involved 60 patients with diabetic foot infections with or without osteomyelitis. The patients were categorised as group 1 mild and group 2 moderate. Both groups were treated using local wound debridement and the systemic administration of antibiotics. Group 1 (16) patients were treated with two regimens of oral antibiotics in two regimens, A (amoxicillin/clavulanate + metronidazole) and B (clindamycin + metronidazole), for 10-14 days. Group 2 (42) patients were treated with oral plus intravenous antibiotics in two regimens, A (ampicillin + cloxacillin + metronidazole) and B (lincomycin + metronidazole), for 6 weeks. The patients followed-up with local wound care specialists for 3 months to evaluate the treatment outcomes (cure, improvement, or failure). RESULTS: Group 1 had an 80% cure rate under regimen A and a 100% cure rate under regimen B. Group 2 regimen A patients had a 61.5% cure rate and 11.53% improved, while regimen B patients had a 68.75% cure rate and 12.5% improved. Failure in both regimens was 23.8% in 20 patients with osteomyelitis, while 35% were cured and 20% improved during the study period. CONCLUSION: Local surgical wound care for 3 months with antibiotic regimens for 6 weeks resulted in good response and cure rates, with lower costs and fewer instances of hospitalisation. Intravenous lincomycin and oral metronidazole achieved higher cure responses for moderate diabetic foot infections

Study The Microbial Content for Some Cafeterias and Restaurants Foods in Babil Province

 أجريت هذه الدراسة لتحليل الجودة الميكروبيولوجية للأغذية التي تباع في الكافتريات الجانبية والمطاعم في بعض مناطق محافظة بابل وقد شملت المطاعم من الدرجة الاولى والمستويات الاخرى، جمعت نماذج من الرز ، اللحم الاحمر، لحوم الدجاج ،الخبز ،البسكويت  والعصائر للفترة من تشرين الثاني / 2016 ولغاية شباط / 2017 . تناولت هذه الدراسة المحتوى المايكروبي  للمواد الغذائية الأكثر استهلاكا في الكافتريات  والمطاعم التي تم اجراء الدراسة فيها في مناطق ناحية الاسكندرية ،القرية العصرية ،اقضية المحاويل ،المسيب والحلة .عند اجراء الزرع المختبري للعينات الماخوذة من الاطعمة واجراء الاختبارات الكيموحيوية للبكتريا النامية على الاوساط الزرعية فقد تبين وجود بكتريا القولون Escherichia . coli  ، بكتريا المكورات العنقودية الذهبية     Staphylococcus aureus ، Staphylococcus epidermidis  ، بكتريا السالمونيلا Salmonella typhi  ، بكتريا الشيغلا Shigella dysentriae    وكذلك نمو بعض الفطريات على الاوساط الزرعية الخاصة بها .   تبين من خلال هذه الدراسة ايضا  أن المواد الغذائية المطبوخة  أظهرت حمولة أقل للجراثيم من الاطعمة الطازجة . كذلك اظهرت النتائج ان الأطعمة المستعملة في المطاعم أقل حمولة ميكروبية من الكافتريات . هذه الدراسة تسلط الضوء  على مستوى المحتوى الميكروبي الموجود في الأطعمة المختلفة المتاحة في الكافتريات والمطاعم .This study was conducted to investigate  the microbiological  contamination of  some solid food  in the cafeterias and restaurants in some areas of Babil province, which included restaurants of the first class and other levels, rice, red meat, chicken meat, bread, biscuits and juices were collected for the period from November 2016 to February 2017.  This study, through the microbiological analysis of the most consumed food in the cafeterias and restaurants that were studied in the areas of Alexandria and the modern village and the districts of  Mahaweel, Masib and Hilla.In vitro culturing  of food samples and biochemical tests of  bacteria on culture media, Escherichia coli was found, Staphylococcus epidermidis, Staphylococcus aureus, Salmonella typhi, Shigella dysentriae and some fungi on their culture media. The study also showed that cooked foods loaded by alower   germs than fresh foods. The results also showed that the foods used in restaurants are less than a microbial load of cafeterias. This study highlights the level of microbial content found in different foods available in cafeterias and restaurants

Management of glucose 6-phosphate dehydrogenase (G6PD) deficient patients undergoing open-heart surgery

Background: There are scarce studies on the management of glucose 6-phosphate dehydrogenase (G6PD) deficient patients during cardiac surgery. The purposes of this retrospective study were to present and evaluate our experience with G6PD deficient patients who underwent cardiac surgery with cardiopulmonary bypass (CPB). Methods: We included 20 patients with G6PD deficiency who had cardiac surgeries from 2015 to 2019. We used free radical scavenging strategy and careful perioperative management. The patients were compared to a control group of 20 patients with normal G6PD enzyme activity who underwent the same type of operations in the same period. Results: Males represented 80% of G6PD deficient patients. There were significant elevations in preoperative total bilirubin (1.03±0.33 vs. 0.57±0.11 mg/dl, p< 0.001) and reticulocytes (1.87±0.62 vs. 0.54±0.18%) in G6PD deficient patients. Valve surgery was done for 60% of G6PD deficient patients. There were no significant differences between both groups regarding the type of surgery, aortic cross-clamp, CPB, and total operative time. G6PD deficient patients had significantly lower postoperative hemoglobin levels (9.44±0.94 vs. 10.0±0.59 g/dl, p= 0.04) and significantly higher postoperative total bilirubin (1.51±0.51 vs. 0.98±0.45 mg/dl; p=0.002) and reticulocytes (1.85±0.51 vs. 0.57±0.13%; p< 0.001). There was no significant difference regarding postoperative urea and creatinine levels. Ventilation time (10.3±2.7 vs. 8.2±1.9 hours; p=0.01), ICU stay (3.1±0.87 vs. 2.3±0.71 days; p=0.004), and hospital stay (3.1±0.87 vs. 6.0±1.02 days; p<0.001) significantly increased in G6PD deficient patients. The mortality rate was 5% (one patient) in G6PD deficient patients. Conclusion: Despite the management strategy, G6PD deficient patients undergoing cardiac surgery are more liable to hemolysis and hypoxia with more need for blood transfusion and longer ventilation time, ICU, and hospital stays when compared to patients with normal G6PD enzyme activity. Further research to improve the outcomes in G6PD deficient patients is required

Effect of Soil Types on the Development of Water Levels and Erosion Processes during Overtopping Test

The construction of dike materials is an essential parameters in controlling the safety of hydraulic engineering. The dike material is an earthfill material constructed from non-cohesive materials or mixed from cohesive and non-cohesive materials. Overtopping failure can affect the dike stability during water cross above dike crest and could threat people lives and property. It is reduced the matric suctions binds soil particles due to the increasing volumetric water content during the transition of water level from the upstream into downstream slopes. In this paper, two spatial overtopping tests are conducted in Hydraulic Geotechnical laboratories at the Universiti Sains of Malaysia to observe the evolution of horizontal and vertical water levels as well as the development of lateral and vertical erosion processes under constant inflow discharge of 30 L/min. The vertical and horizontal water levels as well as the vertical erosion process are measured using one digital camera installed in front of dike embankment, while the horizontal erosion process was measured using another digital camera installed in front of downstream slope. Two types of coarse sand and very silty sand soils are used to construct dike embankment in small flume channel. The small flume is constructed from transparent PVC material to observe the development of water distributions and erosion processes with sediment box to collect the eroded materials. A pilot channel is cut in dike crest along the side wall of small flume channel to initiate breach channel in the dike crest. The initiation of breach channel is crucial for the evolution breach channel failure in the downstream and upstream slopes. The results show that the vertical and horizontal water levels are distributed faster in coarse sand soil compared with those in the very silty sand soil while the horizontal water levels are distributed faster than vertical water levels for both soils.  The permeability of coarse sand increases the velocity of water flow for occupation soil particles and beginning failure in dike crest faster. The presence of fine particles in the very silty sand has reduced the rate of erosion processes inside dike particles in horizontal and vertical directions. The fine particles absorb a large amount of water content and, thus reduce the easiest water infiltration into particles with higher matric suctions. The analyzing of the distributions of water levels and erosion process help to understand the behavior of dike embankment during overtopping failure and increase the maintenance for dikes parts to reduce the potential danger