Mean platelet volume (MPV) and plasma lactate level in the diagnosis and prognosis of neonatal bacteremia

Background: Neonatal sepsis is a life-threatening clinical condition. It is associated with high morbidity and mortality if not treated properly. Blood culture remains the gold standard method diagnosis of sepsis, but it takes at least 24 hours for presumptive diagnosis. Owing to the fact that neonates are vulnerable and can deteriorate easily, rapid diagnosis and management is a must. Aim of the work:Determination of the role of mean platelet volume (MPV) and plasma lactate level in the diagnosis and prognosis of neonatal bacteremia. Methods:Study included 108 clinically septic neonates aged 0-28 days. All neonates were subjected to blood culture, complete blood picture (for MPV evaluation), CRP and blood lactic acid level. Results: The current study showed that there was a significant difference between cases and controls as regards MPV, CRP, and lactate with higher mean and median values among cases with P value 0.001, 0.003, and 0.021 respectively. High blood lactic acid level was found to be highly significant in non-survived neonates when compared to the survived ones with P value 0.001. Conclusion: MPV and Blood lactic acid (BLA) tests are simple, rapid, and inexpensive methods to diagnose neonatal bacteremia. The available evidence confirms significantly higher MPV, and BLA in neonates with bacteremia compared to neonates with non-bacteremia causes of sepsis. Therefore, in clinical practice, MPV and BLA could be used as indicators for the early diagnosis of sepsis, while blood lactic acid can be used as well as a predictor of mortality

COVID-19 associated mucormycosis and diabetes mellitus: An exploratory study

Background:Mucormycosis has abruptly increased in Egypt during the third wave of COVID-19 especially in patients with diabetes mellitus (DM). The aim of this study was to investigate the risk factors, clinical presentation and outcome of mucormycosis in COVID-19 patients with diabetes. Methods: Prospective cohort study was conducted on 72 COVID-19 patients with DM presented with mucormycosis at intensive care units and Ear, Nose, and Throat Department of Zagazig University Hospitals over a period of three months from May 2021 to August 2021. All participants were submitted to history taking, examination, laboratory investigation, radiological and histopathology and culture testing. Results: Post COVID-19 new-onset diabetes mellitus (NOD) was detected in 40% of studied patients. 72.2% of patients had poorly controlled diabetes. Majority of studied patients presented by rhino-orbital mucormycosis (90.3%) and about 86% of them were operated. Hundred percent of patients gave history of antibiotic use and also nearly 99.0% of them received corticosteroids, while only 1.4% of them received tocilizumab. There was statistically significant association between operated patients, hemoglobin (HB) level, lymphocyte count, neutrophil-lymphocyte ratio (NLR), and CRP level with disease prognosis. Conclusions: Poorly controlled DM and steroid use are the most important risk for post COVID-19 mucormycosis. Early surgical intervention carried better disease outcome

Mitigating and Adapting to Climate Change: Solutions for the Tourism Sector in Egypt/ التخفيف والتكيف مع تغير المناخ: حلول لقطاع السياحة في مصر

Climate change is soon becoming an unescapable challenge for many countries, Egypt included. Severe weather events are becoming more and more frequent and developing countries are expected to be more vulnerable to their effects. Tourism is considered one of the most vulnerable sectors affected by climate change, not only due to risks to marine life coastal communities, but also because changes in temperatures are expected to affect tourists preferred destinations. This is especially challenging for Egypt given that Tourism contributes up to 15% of GDP, is one of the countries’ main sources of foreign currency, and employs more than 10% of the workforce. This policy brief presents four different recommendations to adapt and mitigate climate change effects to the tourism industry in Egypt. The recommendations were formulated after several meetings with respective stakeholders in the Ministry of Tourism & Ministry of Environment. The recommendations in this policy brief are based on the integrated reform program of the Ministry of Tourism and Egypt’s and Egypt’s National Climate Strategy for 2050

Investigation of photon, neutron and proton shielding features of H3BO3–ZnO–Na2O–BaO glass system

The current study aims to explore the shielding properties of multi-component borate-based glass series. Seven glass-samples with composition of (80-y)H3BO3–10ZnO–10Na2O–yBaO where (y = 0, 5, 10, 15, 20, 25 and 30 mol.%) were synthesized by melt-quench method. Various shielding features for photons, neutrons, and protons were determined for all prepared samples. XCOM, Phy-X program, and SRIM code were performed to determine and explain several shielding properties such as equivalent atomic number, exposure build-up factor, specific gamma-ray constants, effective removal cross-section (SR), neutron scattering and absorption, Mass Stopping Power (MSP) and projected range. The energy ranges for photons and protons were 0.015–15 MeV and 0.01–10 MeV, respectively. The mass attenuation coefficient (µ/?) was also determined experimentally by utilizing two radioactive sources (166Ho and 137Cs). Consistent results were obtained between experimental and XCOM values in determining µ/? of the new glasses. The addition of BaO to the glass matrix led to enhance the µ/? and specific gamma-ray constants of glasses. Whereas the remarkable reductions in SR, MSP, and projected range values were reported with increasing BaO concentrations. The acquired results nominate the use of these glasses in different radiation shielding purposes

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

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Growth Performance, Hematological Characteristics and Carcass Merits in Four Different Duck Breeds

This work was conducted to investigate the growth performance, hematological characteristics, and carcass merits in four duck breeds (Pekin, Star 53, Muscovy and Mulard ducks). A total 80 ducklings one day old were used in this work till the age of 12 weeks. Each of the ducklings was allocated to 4 replicates (5 ducks/replicate). The obtained results denoted that the Mulard had the heaviest body weight (4234 gm) followed by Muscovy, Star 53 and Pekin (4029, 3659 and 2938 g., respectively). Muscovy ducks had a highly significant dressing percentage (84.39 %) compared to that of Mulard, Pekin and Star 53 (83.23, 74 and 72.72 %, respectively). Mulard duck had the highest values in Hemoglobin and MCHC by (25 and 49 %) in Pekin and Star but (32 and 24 %) in Muscovy. Lymphocyte in Muscovy increased about two times of Pekin, Star 53. Conclusion, performance, carcass characteristics, and blood parameters were all generally better with Mulard ducks.