Hypophosphatemia and Hyponatremia in Systemic Lupus Erythematosus Patients and Its Relation to Clinical Characteristic and Disease Activity

Background: Systemic Lupus Erythematosus (SLE) is a chronic auto-immune disease with diverse manifestations, ranging from mild rash or arthritis to severe organ-threatening involvement.Objective: The aim of the work was to find-out the possible association of hypophosphatemia and hyponatremia with disease activity in SLE patients.Patients and methods: A total of 100 patients with SLE were involved in this study and the serum level of sodium and phosphorus, erythrocyte sedimentation rate (ESR), leucocytic and platelet counts, and 24 hr. protein were measured. SLE disease activity index (SLEDAI) score was assessed,Results: The majority of patients were females; 94 (94%) and 6 males (6%) (F:M 15.7:1). The age of the patient ranged from 17 to 63 years with a mean age of 34.23 ±11.19 years. The disease duration was 48±55.7 months. 7. 41% of SLE patients were hyponatremic and 49% showed normonatremic. There was a significant correlation between Na level, SLEDAI score, vasculitis and arthritis and insignificant correlation with ESR. 47 patients were hypophosphatemic  (47%) and 53 (53%) were normophophatemic. There was a significant correlation between phosphate level and SLEDAI, oral ulcers p=0.001 and arthritis p<0.0004 but negatively related with ESR.Conclusion: It could be concluded that hyponatremia and hypophosphatemia are significantly related to SLEDAI, so it could be used as indicators of SLE activity and sever inflammation

Enhancement of alpha amylase production by Aspergillus flavus AUMC 11685 on mandarin (Citrus reticulata) peel using submerged fermentation

Mandarin peel as submerged fermentation (SmF) source was tested for the production of alpha amylase enzyme by strain of Aspergillus flavus AUMC 11685. Incubation period, concentration of substrate, temperature, pH and size of inoculum were optimized to achieve the maximum production of alpha amylase enzyme by Aspergillus flavus using mandarin peel. The maximum production of alpha amylase enzyme by Aspergillus flavus was recorded at 4-5 days of incubation, 3% substrate concentration, inoculum concentration 10%, temperature 28-40°C and pH 4-5.5. DOI: http://dx.doi.org/10.5281/zenodo.81827

Experimental and Theoretical Cross Sections for Molecular-frame Electron-impact Excitation-ionization of D₂

We present both experimental and theoretical results for the dissociative ionization of D2 molecules induced by electron impact. Cross sections are determined in the molecular frame and are fully differential in the energies and emission angles of the dissociation fragments. Transitions are considered from the X1Σg+ electronic ground state of D2 to the 2sσg, 2pπu and 2pσu excited states of D2+. The experimental results are compared to calculations performed within the molecular four-body distorted-wave framework to describe the multicenter nature of the scattering process. The cross sections reveal a dramatic dependence on both the alignment of the internuclear axis with respect to the direction of the projectile momentum and on the symmetry of the excited dissociating state which is energetically resolved

SAPONINS, GLYCOSIDES AND FLAVONOIDS IN CELLS AND TISSUES OF BALANITES AEGYPTIACA CULTURED ON SOLID AND LIQUID CULTURE MEDIA

Objectives: The main objective of the present study is to obtain callus and cell suspension culture from Balanitesa egyptiaca sterile plantlets grown in vitro and to compare growth and the biosynthetic potential of saponins, flavonoids and glycosides by callus and cell suspension culture Balanitisa egyptiaca. Methods: Callus was induced from the mother plants on MS culture media supplemented with  2.0 mg/l  BA + 2.0 mg/l  2,4-D with and without agar gelling. Total saponins, glycosides and flavonoids were estimated in both types of cultures over a period extending from 1 to 5 weeks to compare the productivity of such secondary metabolites in callus and cell suspension cultures. Results: The results obtained indicated that both calli and cell suspension cultures were able to synthesize the target active ingredients and that cell suspension culture was superior to the callus culture in the biosynthesis and accumulation processes. By the end of the incubation period, the amount of total saponins in cell suspension culture reached up 51.97±0.26 dry biomass compared to 35.02 ±0.06 mg/g in callus culture. The amount of total flavonoids in cell suspension culture reached up 10.88±0.24 dry biomass compared to 6.40±0.02 mg/g in callus culture and of total glycosides reached up 6.11±0.25 dry biomass compared to 5.06 ±0.05 mg/g in callus culture. Conclusions: The results obtained in this study may indicate the promising role that plant cell culture will play in the future in phytopharmaceutical industry.                          Peer Review History: Received 16 July 2020; Revised 12 August; Accepted 26 August, Available online 15 September 2020 Academic Editor: Dr. Iman Muhammad Higazy, National Research Center, Egypt, [email protected] UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency.  Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.5/10 Reviewer(s) detail: Dr. Gehan Fawzy Abdel Raoof Kandeel, Researcher at pharmacognosy Department, National Research Centre, Egypt, [email protected] Ahmad Najib, Department of Pharmacognosy-Phytochemystry Universitas Muslim Indonesia-Indonesia, [email protected] Similar Articles: PHYTOCHEMICAL ANALYSIS AND ANTIMICROBIAL ACTIVITY OF COLOCASIA ESCULENTA (TARO) MEDICINAL PLANT LEAVES USED IN FOLK MEDICINE FOR TREATMENT OF WOUNDS AND BURNS IN HUFASH DISTRICT AL MAHWEET GOVERNORATE–YEMEN PHYTOCHEMICAL SCREENING AND THIN LAYER CHROMATOGRAPHIC OF PRUNUS DULCIS (ALMOND) MEDICINAL PLANT LEAVES USED IN FOLK MEDICINE FOR TREATMENT OF WOUNDS AND BURNS IN HUFASH DISTRICT AL MAHWEET GOVERNORATE–YEME

Theoretical and experimental study of (e,2e) ionization of the CO₂ (1π\u3csub\u3eg\u3c/sub\u3e) molecule at 250 eV

Triple differential cross sections (TDCSs) of the electron-impact ionization of carbon dioxide are measured in the coplanar asymmetric geometry, with incident electron energy value of 250eV, and ejected electron of 37eV. We will report the experimental results in comparison with the theoretical calculations of the M3DW and TCC (type 5) calculations

Humoral Immunogenicity and Efficacy of a Single Dose of ChAdOx1 MERS Vaccine Candidate in Dromedary Camels

MERS-CoV seronegative and seropositive camels received a single intramuscular dose of ChAdOx1 MERS, a replication-deficient adenoviral vectored vaccine expressing MERS-CoV spike protein, with further groups receiving control vaccinations. Infectious camels with active naturally acquired MERS-CoV infection, were co-housed with the vaccinated camels at a ratio of 1:2 (infected:vaccinated); nasal discharge and virus titres were monitored for 14 days. Overall, the vaccination reduced virus shedding and nasal discharge (p = 0.0059 and p = 0.0274, respectively). Antibody responses in seropositive camels were enhancedby the vaccine; these camels had a higher average age than seronegative. Older seronegative camels responded more strongly to vaccination than younger animals; and neutralising antibodies were detected in nasal swabs. Further work is required to optimise vaccine regimens for younger seronegative camels

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

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

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

The global, regional, and national burden of adult lip, oral, and pharyngeal cancer in 204 countries and territories:A systematic analysis for the Global Burden of Disease Study 2019

Importance Lip, oral, and pharyngeal cancers are important contributors to cancer burden worldwide, and a comprehensive evaluation of their burden globally, regionally, and nationally is crucial for effective policy planning.Objective To analyze the total and risk-attributable burden of lip and oral cavity cancer (LOC) and other pharyngeal cancer (OPC) for 204 countries and territories and by Socio-demographic Index (SDI) using 2019 Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study estimates.Evidence Review The incidence, mortality, and disability-adjusted life years (DALYs) due to LOC and OPC from 1990 to 2019 were estimated using GBD 2019 methods. The GBD 2019 comparative risk assessment framework was used to estimate the proportion of deaths and DALYs for LOC and OPC attributable to smoking, tobacco, and alcohol consumption in 2019.Findings In 2019, 370 000 (95% uncertainty interval [UI], 338 000-401 000) cases and 199 000 (95% UI, 181 000-217 000) deaths for LOC and 167 000 (95% UI, 153 000-180 000) cases and 114 000 (95% UI, 103 000-126 000) deaths for OPC were estimated to occur globally, contributing 5.5 million (95% UI, 5.0-6.0 million) and 3.2 million (95% UI, 2.9-3.6 million) DALYs, respectively. From 1990 to 2019, low-middle and low SDI regions consistently showed the highest age-standardized mortality rates due to LOC and OPC, while the high SDI strata exhibited age-standardized incidence rates decreasing for LOC and increasing for OPC. Globally in 2019, smoking had the greatest contribution to risk-attributable OPC deaths for both sexes (55.8% [95% UI, 49.2%-62.0%] of all OPC deaths in male individuals and 17.4% [95% UI, 13.8%-21.2%] of all OPC deaths in female individuals). Smoking and alcohol both contributed to substantial LOC deaths globally among male individuals (42.3% [95% UI, 35.2%-48.6%] and 40.2% [95% UI, 33.3%-46.8%] of all risk-attributable cancer deaths, respectively), while chewing tobacco contributed to the greatest attributable LOC deaths among female individuals (27.6% [95% UI, 21.5%-33.8%]), driven by high risk-attributable burden in South and Southeast Asia.Conclusions and Relevance In this systematic analysis, disparities in LOC and OPC burden existed across the SDI spectrum, and a considerable percentage of burden was attributable to tobacco and alcohol use. These estimates can contribute to an understanding of the distribution and disparities in LOC and OPC burden globally and support cancer control planning efforts