Development Program to Estimate the Suitable of Raw Materials to Produce Cement

Raw material composition plays an essential role on the lining life of cement rotary kiln.They are obtained from hard rock quarries that represent the first step in the cement manufacturing process. That raw materials are transported to Al- Kufa cement plant then crushed and ground to very fine powder and then blended in the correct proportions.This research aims to study suitable rations of raw materials to produce cement in al Kufa cement plant in Iraq. Through a software program, suitale raw materials ratios for the clinker were estimated, then chemical and physical tests for clinker and cement according to Iraqi Standard Specification were done to recognize the effects on the properties of cement such as the ratios of major and minor oxides, Lime saturations factor (LSF), Silica Modulus (SM) Alumina Modulus (AM), compressive strength, setting time and soundness. Keywords: Portland Cement, Raw material, Cement industry, Rotary kiln and Factors Affective of clinker DOI: 10.7176/CER/11-1-0

Histological and Histomorphometric illustration the endochondral ossification of the mandibular angle defect repair in rats after oral stimulation with bisphosphonate treatment (an in vivo study)

Background: Bio-phosphonates can be used to lower the risk of hip and spine fractures. Additionally, they can be used to treat Paget's disease of the bones in a variety of dosages. In the procedure that  replace hyaline cartilage to  bone, this procedure i.e.  called endochondral ossification. It starts when mesenchymal cells from the mesoderm develop into chondrocytes. Chondrocytes multiply quickly and release an extracellular matrix to create the cartilage that serves as the model for bone. Objective: To histomorphometric illustration the endochondral ossification of the mandibular angle defect repair in rats  after oral stimulation with bisphosphonate treatment. Patients and Methods: 20 rats were used in this work and the animals were divided into the following groups: 10 Rats from the control group. The bone defect was healed naturally without medicament and 10 rats were used in the experiment, and taking the biophosphonate medication helped mend the bone defect. Every single group was studied in 7 and 14 day (5 rats for each healing period) and the surgical procedure was performed for histological and Histomorphometrically examination. The data analysis with spss statistic measure & with P vale (P ≤ 0.05). Results: Active effect of the bio-phosphate medicament in the endochondral ossification and the cell that responsible for the cartilage formation and accelerated the healing of the mandibular defect with inhibition of the bone resoption and finally decrease the time that need to full healing. Conclusion: The chemical medicament that represented by bio-phosphonate accelerated the endochondral ossification in a short time and replacement with bone in the site of the defect

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

Amebic Liver Abscess: A disease native to Oman?

Objective: Amebic liver abscess (ALA) is endemic to many areas of the world. In this study we sought to investigate the epidemiology, presentation, laboratory tests and imaging characteristics related to ALA in Oman and ultimately determine whether ALA is native to Oman or is it imported from abroad. Methods: This case series study was conducted at Royal Hospital Muscat, Oman. Patient data was extracted from the Royal Hospital patient database and included patients older than 13 years of age, discharged with the discharge diagnosis of ALA from January 2013 to December 2017. Results: 22 patients were included in the study. The results showed 18 Omani patients and 4 expatriates. Only two Omanis had history of travel abroad. 15 patients were male and 7 females. The average age was 45.2. The most common presentation was abdominal pain seen in 17 patients. Fever was seen in 13 patients. Alanine transferase was found to be elevated in 13 patients. 90% of patients had no symptomatic infections prior to developing ALA. Conclusion: The data suggests that ALA is endemic to Oman given the higher number of local patients and the lack of travel abroad in this population. As the number of treated ALA patients is rather small, it can be concluded that the occurrence of ALA is much lower in Oman as compared to other endemic areas. The majority of patients had no prior symptomatic infections and thus a method of control would be to screen and prevent amebic spread. Keywords: Amebic liver abscess, Amebiasis, liver abscess, Entamoeba histolytica, Royal Hospital, Oma

Characteristics of Pyogenic Liver Abscess: Experience of a Single Centre in Oman

Objectives: Liver abscess can develop as a complication of hepatobiliary disease or other intraabdominal infections, but more recently it is associated with primary and secondary liver malignancies and their treatment. The goal of this study was to analyze the epidemiology, etiology and clinical characteristics of pyogenic liver abscess in Oman. The intention was to obtain the information needed for the adequate liver abscess empirical treatment. Methods: This retrospective study took place in a tertiary hospital. Consecutive patients treated for the liver abscess during the five years period, from January 2013 until the end of 2017, were enrolled. Their demographic and clinical data were used to study the characteristics of pyogenic liver abscess in Oman. Results: Fifty-three patients with pyogenic liver abscess were enrolled in the study. They were predominantly male and younger than 60 years. Klebsiella pneumoniae was the most usual bacteria causing the liver abscess. Clinical presentation was unspecific and the abdominal pain and high fever were the most usual symptoms. Conclusion: The majority of pyogenic liver abscesses are caused by K. pneumoniae so the empirical treatment should be started with antibiotic directed against it. Further studies are needed to establish the local role of anaerobic bacteria in pyogenic liver abscess as well as to monitor the presence of hypervirulent K. pneumoniae in Oman. Keywords: Pyogenic liver abscess; Etiology; Epidemiology; Klebsiella pneumoniae