Liver function status in bacterascites versus spontaneous bacterial peritonitis in patients with liver cirrhosis

Background: Spontaneous bacterial peritonitis (SBP) is a severe complication of decompensated cirrhosis, and the in hospital mortality for SBP ranges from 21.3% to 37%.Objective: The aim of the present study was to assess the clinical characteristics, microbiological findings, and clinical course in patients diagnosed with bacterascites in comparison with patients with spontaneous bacterial peritonitis, regarding liver status.Patients and methods: This study was conducted on 50 Patients with ascites who were admitted at Internal Medicine Department, Benha University Hospital.Results: There was no significant difference between the two studied groups. There was no significant difference between the two studied groups regarding hemoglobin, total leukocyte count (TLC) and platelets. There was no significant difference between the two studied groups regarding liver parameters. There was a significant difference between the two studied groups regarding polymorphonuclear neutrophil (PMN) count. There was a significant difference between the two studied groups regarding positive cultures and prevalence of isolated organisms from the ascitic fluid. There was a significant difference between the two studied groups regarding antimicrobial agents use.Conclusion: Bacterascites is a complication of cirrhosis comparable to SBP with respect to clinical background and prognosis. There is a significant difference between the two studied groups regarding positive cultures and prevalence of isolated organisms from the ascitic fluid. There is a significant difference between the two studied groups regarding antimicrobial agents use

Prolongation of corrected QT interval in diabetic patients with ketoacidosis

Background: Diabetic ketoacidosis (DKA) is the most common acute hyperglycemic complication of diabetes. According to a recent report DKA affects approximately 8 per 1000 diabetics annually. It is associated with significant morbidity and mortality, with a worldwide mortality rate of 2-10%.Objective: The aim of the work was to assessment of QTc interval prolongation among patients with DKA.Patients and Methods: This prospective observational cohort study included 100 patients who were diagnosed with DKA. The mean age of patients was 37.29±11.63 years, and 53% of them were males. All patients were subjected to detailed history taking, full clinical examination, laboratory investigations and 12-lead ECG.Results: Frequency of Prolonged QTmaxc amongst studied patients was 59%. Mean QTmaxc declined significantly after treatment to be 414.6±44.1ms compared to 482.45±63.56ms before treatment with p<0.0001 and Frequency of prolonged QTmaxc was significantly decreased with treatment from 59% to 20%. Anion gap was significantly higher for Prolonged QTmaxc patients compared to normal QTmaxc patients p<0.0001. While ABG (PH, HCO3) were significantly lower for Prolonged QTmaxc patients compared to normal QTmaxc patients p<0.0001. Logistic regression revealed that anion gap was significant independent risk factor for QTmaxc prolongation while.Conclusion: patients with DKA have a potential risk of QTmaxc interval prolongation due to acidosis regardless electrolytes abnormalities, and associated with a relative risk of 1.732-fold for mortality. Carful measuring of anion gap at time of admission can be used in diagnosis and prediction of occurrence of prolonged QTmaxc with high sensitivity and specificity

A New Flavonoid C-Glycoside from Celtis australis L. and Celtis occidentalis L. Leaves and Potential Antioxidant and Cytotoxic Activities

A major development over the past two decades has been the realization that free radical induced lipid peroxidation and DNA damage are associated with major health problems, e.g. cancer and ageing. Plant-derived antioxidants are increasingly found beneficial in protecting against these diseases. Celtis australis L. and Celtis occidentalis L. are two plants that have a variety of uses in folk medicine but have not been evaluated before for their antioxidant and cytotoxic properties. Therefore, the extracts of both plants’ leaves were investigated for these activities, as well as isolation of the bioactive compounds responsible for the activities. Molecular structures of the compounds were elucidated by UV, HRESIMS, 1D (1H and 13C) and 2D (1H-13C HSQC and 1H-13C HMBC) NMR analyses. The ethanolic and aqueous extracts, n-butanol fractions and the isolated major compound were tested for their antioxidant activity using DPPH radical scavenging assay, xanthine oxidase-induced generation of superoxide radical and lipid peroxidation assay by thiobarbituric acid-reactive substances (TBARS) method using rat tissue homogenates. Cytotoxic activities were studied using standard MTT assay. A novel flavonoid C-triglycoside, 4‴-α-rhamnopyranosyl-2″-O-β-d-galactopyranosylvitexin, was isolated from both plants’ leaves, together with seven known flavonoids. The n-butanol fractions and the major compound 2″-O-β-galactopyranosylvitexin showed significant antioxidant activities, more pronounced than the tested standards BHT and dl-α-tocopherol in most tests. All extracts showed variable cytotoxic activities. This study provides strong evidence for the antioxidant and cytotoxic activities of the extracts of Celtis australis L. and Celtis occidentalis L. leaves, which were attributed to the polar n-butanol fractions and the major isolated flavonoid 2″-galactosylvitexin

Prevalence of Neospora caninum and Toxoplasma gondii Antibodies and DNA in Raw Milk of Various Ruminants in Egypt.

The prevalence of Neospora caninum and Toxoplasma gondii antibodies in raw milk samples was estimated in different ruminants and Egyptian governorates. Of 13 bulk milk samples tested by ELISA, five (38.5%) were positive for antibodies to N. caninum, and two samples were additionally positive for antibodies to T. gondii, resulting in a seroprevalence of 15.4% for both T. gondii and co-infection. In individual milk samples (n = 171) from the same bulks, antibodies to N. caninum were detected in 25.7%, to T. gondii in 14%, and 3.5% had antibodies to both parasites. A strong correlation between the OD values of the bulk samples and of the relevant individual milk samples was found for T. gondii (Pearson r = 0.9759) and moderately strong for N. caninum (Pearson r = 0.5801). Risk factor assessment for individual milk samples revealed that antibodies to T. gondii were significantly influenced by animal species, while no risk factors were detected for N. caninum antibodies. Additionally, DNA of N. caninum was detected in a bulk milk sample of cattle for the first time in Egypt, and DNA of T. gondii was found in bulk milk samples of cattle, sheep and goats. This is the first study in Egypt in which bulk milk samples of different ruminants were tested for the presence of N. caninum and T. gondii antibodies and DNA. Both individual and bulk milk samples are useful tools for monitoring antibody response to N. caninum and T. gondii infections in different ruminants in Egypt

Synthesis and characterisation of sulphonamide (Schiff base) ligand and its copper metal complex and their efficiency in polyurethane varnish as flame retardant and antimicrobial surface coating additives

Sulphonamide compounds are present in many bioactive compounds owing to their multiple biological applications, even their metal complexes. The study reported in this paper focused on the synthesis of a sulphonamide ligand (Schiff base) and its Cu metal complex and their possible applications as antimicrobial and flame retardant additives in polyurethane formulations for surface coating application. Thus, selected divalent (Cu II) metal complex of 4-((E)-(4-hydroxy-3-((E)-(p-tolylimino)methyl) phenyl) diazenyl)-N-(5-methylisoxazol-3-yl) benzenesulphonamide was prepared and characterised using a combination of elemental analysis, Fourier Transform Infrared, Proton Nuclear Magnetic Resonance and mass spectroscopy. The prepared Schiff base ligand and its Cu metal complex were physically added to polyurethane varnish to give varnish coating formulations at a laboratory scale and then applied onto pretreated wood and steel panels using a brush. The oxygen index, Gram negative bacteria; Gram positive bacteria and fungi values obtained indicated that the polyurethane varnish that contained the prepared ligand and its Cu metal complex as additives exhibited very good flame retardant and antimicrobial properties, respectively. It was also found that the metal complex had outperformed the ligand. The physical and mechanical resistance of the coatings was also studied, in order to assess any disadvantages owing to the incorporation of the additives. It was found that the additives did not influence the flexibility, hardness and adhesion of coating films prepared using the polyurethane varnish. The gloss of the polyurethane varnish film was improved due to the incorporation of the aromatic ring into the formulation

Seroprevalence of Toxoplasma gondii and Neospora caninum in camels recently imported to Egypt from Sudan and a global systematic review.

INTRODUCTION Toxoplasma gondii and Neospora caninum are closely related intracellular protozoan parasites of medical and veterinary concern by causing abortions and systemic illness. Limited or ambiguous data on the prevalence of T. gondii and N. caninum in camels triggered us to conduct this study. METHODS Camels (n = 460) recently imported from Sudan and destined mainly for human consumption, were tested for specific antibodies against these protozoans using commercially available ELISAs. From the two only quarantine stations for camels from Sudan, 368 camels were sampled between November 2015 and March 2016 in Shalateen, Red Sea governorate, and 92 samples were collected between September 2018 and March 2021 from Abu Simbel, Aswan governorate. RESULTS & DISCUSSION Overall, seropositive rates in camels were 25.7%, 3.9% and 0.8% for T. gondii, N. caninum and mixed infection, respectively. However, marked differences were found between the two study sites and/or the two sampling periods: For T. gondii, a higher rate of infection was recorded in the Red Sea samples (31.5%, 116/368; odds ratio 20.7, 5.0-85.6; P<0.0001) than in those collected in Aswan (2.2%, 2/92). The opposite was found for N. caninum with a lower rate of infection in the Red Sea samples (0.82%, 3/368; odds ratio 23.7, 6.7-83.9; P<0.0001) than in the samples from Aswan (16.3%, 15/92). Additionally, our systematic review revealed that the overall published seroprevalence of T. gondii and N. caninum was 28.6% and 14.3% in camels worldwide, respectively. To the best of our knowledge, this study provides the first record of seroprevalence of both T. gondii and N. caninum in recently imported camels kept under quarantine conditions before delivery to other Egyptian cities and regions. In addition, our review provides inclusive data on the prevalence of T. gondii and N. caninum in camel globally. This knowledge provides basic data for the implementation of strategies and control measures against neosporosis and toxoplasmosis

Overwhelming postsplenectomy infection due to Mycoplasma pneumoniae in an asplenic cirrhotic patient: Case report

<p>Abstract</p> <p>Background</p> <p><it>Mycoplasma </it><it>pneumoniae </it>infection is usually self-limited, but some fulminant cases are fatal, even when occurring in previously healthy individuals. It can also be the cause of overwhelming postsplenectomy infection (OPSI).</p> <p>Case presentation</p> <p>We report a case of OPSI in a 41-year-old woman with hypersplenism associated with hepatitis B cirrhosis. We detected a significant <it>Mycoplasma pneumoniae </it>agglutination titer, but no evidence of infection with <it>Chlamydia pneumoniae, Legionnella spp</it>., or any other bacterial or fungal pathogens. She eventually died despite aggressive therapy.</p> <p>Conclusions</p> <p><it>M. pneumoniae </it>could be an underestimated cause of OPSI, and should be suspected in fulminant infectious cases in asplenic patients.</p

Physicians Report Barriers to Deliver Best Practice Care for Asplenic Patients: A Cross-Sectional Survey

Background: Current management of asplenic patients is not in compliance with best practice standards, such as defined by the British Committee for Standards in Haematology. To improve quality of care, factors inhibiting best practice care delivery need to be identified first. With this study, we aimed to identify and quantify physicians' barriers to adhere to best practice management of asplenic patients in the Netherlands. Methods and Principal Findings: A cross-sectional survey, preceded by multiple focus group discussions, was performed among Dutch physicians responsible for prevention of infections in asplenic patients, including specialists ( of Internal medicine and Surgery) and general practitioners (GPs). Forty seven GPs and seventy three hospital specialists returned the questionnaire, yielding response rates of 47% and 36,5% respectively. Physicians reported several barriers to deliver best practice. For both GPs and specialists, the most frequently listed barriers were: poor patient knowledge (> 80% of hospital specialists and GPs) and lack of clarity about which physician is responsible for the management of asplenic patients (50% of Internists, 46% of Surgeons, 55% of GPs). Both GPs and hospital specialists expressed to experience a lack of mutual trust: specialists were uncertain whether the GP would follow their advice given on patient discharge (33-59%), whereas half of GPs was not convinced that specialists' discharge letters contained the correct recommendations. Almost all physicians (> 90%) indicated that availability of a national guideline would improve adherence to best practice, especially if accessible online. Conclusion: This study showed that, in accordance with reports on international performance, care delivery for asplenic patients in the Netherlands is suboptimal. We identified and quantified perceived barriers by physicians that prevent adherence to post-splenectomy guidelines for the first time. Better transmural collaboration and better informed patients are likely to improve the quality of care of the asplenic patient population. A national, online-available guideline is urgently require

Hybrid multicriteria fuzzy classification of network traffic patterns, anomalies, and protocols

© 2017, Springer-Verlag London Ltd., part of Springer Nature. Traffic classification in computer networks has very significant roles in network operation, management, and security. Examples include controlling the flow of information, allocating resources effectively, provisioning quality of service, detecting intrusions, and blocking malicious and unauthorized access. This problem has attracted a growing attention over years and a number of techniques have been proposed ranging from traditional port-based and payload inspection of TCP/IP packets to supervised, unsupervised, and semi-supervised machine learning paradigms. With the increasing complexity of network environments and support for emerging mobility services and applications, more robust and accurate techniques need to be investigated. In this paper, we propose a new supervised hybrid machine-learning approach for ubiquitous traffic classification based on multicriteria fuzzy decision trees with attribute selection. Moreover, our approach can handle well the imbalanced datasets and zero-day applications (i.e., those without previously known traffic patterns). Evaluating the proposed methodology on several benchmark real-world traffic datasets of different nature demonstrated its capability to effectively discriminate a variety of traffic patterns, anomalies, and protocols for unencrypted and encrypted traffic flows. Comparing with other methods, the performance of the proposed methodology showed remarkably better classification accuracy

Robustness of optimal channel reservation using handover prediction in multiservice wireless networks

The aim of our study is to obtain theoretical limits for the gain that can be expected when using handover prediction and to determine the sensitivity of the system performance against different parameters. We apply an average-reward reinforcement learning approach based on afterstates to the design of optimal admission control policies in mobile multimedia cellular networks where predictive information related to the occurrence of future handovers is available. We consider a type of predictor that labels active mobile terminals in the cell neighborhood a fixed amount of time before handovers are predicted to occur, which we call the anticipation time. The admission controller exploits this information to reserve resources efficiently. We show that there exists an optimum value for the anticipation time at which the highest performance gain is obtained. 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