Evidence of colistin resistance genes (mcr-1 and mcr-2) in wild birds and its public health implication in Egypt

Background Antimicrobial resistance has become one of the most severe global threats to human and veterinary Medicin e. coli stin is an effective therapeutic agent against multi-drug-resistant pathogens. However, the discovery of transferable plasmids that confer resistance to colistin ( mcr-1) has led to challenges in medical science. This study describes the role of wild birds in the harbouring and environmental spread of colistin-resistant bacteria, which could pose a potential hazard to human and animal health. Methods In total, 140 faecal samples from wild birds (migratory and resident birds) were tested. Twenty surface water samples were collected from the area in which wild bird trapping was conducted, and 50 human stool samples were collected from individuals residing near the surface water sources and farm buildings. Isolation and identification of Enterobacteriaceae and Pseudomonas aeruginosa from the different samples were performed using conventional culture techniques and biochemical identification. PCR amplification of the mcr genes was performed in all positive isolates. Sequencing of mcr -1 genes from three randomly selected E. coli carrying mcr-1 isolates; wild birds, water and humans was performed. Result The bacteriological examination of the samples showing isolates of Escherichia coli , Klebsiella pneumoniae , Klebsiella oxytoca and P. aeruginosa . The results of multiplex PCR of the mcr genes revealed that E. coli was the most prevalent gram-negative bacterium harbouring the mcr genes, whereas a low prevalence was observed for K. pneumoniae . The prevalence of mcr- 1 in resident birds, migratory birds, water sources and humans were 10.4, 20,16.6 and 9.6% while the prevalence of mcr -2 were 1.4, 3.6, 11.1 and 9.6%, respectively. Sequencing of the mcr-1 gene from the three E. coli carrying mcr - 1 isolates indicated a possible correlation between the wild bird and surface water isolates. Conclusion The detection of mcr -1-positive bacteria in wild birds in Egypt indicates the possible environmental dissemination of this gene through bird activity. The impact of the interaction between domestic and wild animals on public health cannot be overlooked.

Correction to: Utilization of Waste Glass Micro-particles in Producing Self-Consolidating Concrete Mixtures

T-Box20 inhibits osteogenic differentiation in adipose-derived human mesenchymal stem cells: the role of T-Box20 on osteogenesis

Background Skeletal development and its cellular function are regulated by various transcription factors. The T-box (Tbx) family of transcription factors have critical roles in cellular differentiation as well as heart and limbs organogenesis. These factors possess activator and/or repressor domains to modify the expression of target genes. Despite the obvious effects of Tbx20 on heart development, its impact on bone development is still unknown. Methods To investigate the consequence by forced Tbx20 expression in the osteogenic differentiation of human mesenchymal stem cells derived from adipose tissue (Ad-MSCs), these cells were transduced with a bicistronic lentiviral vector encoding Tbx20 and an enhanced green fluorescent protein. Results Tbx20 gene delivery system suppressed the osteogenic differentiation of Ad-MSCs, as indicated by reduction in alkaline phosphatase activity and Alizarin Red S staining. Consistently, reverse transcription-polymerase chain reaction analyses showed that Tbx20 gain-of-function reduced the expression levels of osteoblast marker genes in osteo-inductive Ad-MSCs cultures. Accordingly, Tbx20 negatively affected osteogenesis through modulating expression of key factors involved in this process. Conclusion The present study suggests that Tbx20 could inhibit osteogenic differentiation in adipose-derived human mesenchymal stem cells.

Usage of the cyto-genetics and cytology to identify the action mechanisms of two bio-fertilizers on Allium cepa meristematic cells

Bio-fertilizers as a safe alternative to the synthetic fertilizers come to the front in the agriculture requirements as they provide the planted crops with their nutrients to ensure high quality and productivity. Many of them must be screened and examined to configure their effect on the plants. This study was designed to evaluate two promising bio-fertilizers: Moringa oleifera leaf extract (5.0, 10.0, 20.0%) and Sacharomyces cerevisiae aqueous extract (5.0, 10.0, 20.0%) for their safe usage on Allium cepa root meristems as a model system for monocots after 3.0 h of direct treatment. This evaluation focused on both cytogenetic and cytological levels. Cytogenetic studies screened the effect of each extract on the mitotic apparatus considering the mitotic index, mitotic phase index, percentage, and type of abnormalities. Cytological studies with transmission electronic microscope screen the effect of each extract on ultra-structural organelles (mitochondria, endoplasmic reticulum, peroxisomes, dictyosomes in addition to the vacuoles) in the cell cytoplasm. Obtained data revealed that the yeast extract shows a remarkable cytological effect on cytoplasmic organelles. By the same time, only the higher used concentration of Moringa extract shows higher chromotoxic effect on chromosomal DNA despite it shows high proliferation effect on the treated root tip cells. Among the two tested bio-fertilizers, the Moringa extract in lower concentration is more preferable as it does not harm neither the cytoplasmic organelles nor the mitotic apparatus.

Health-related quality of life in a group of Egyptian children and adolescents with type 1 diabetes: relationship to microvascular complications

The increased prevalence of type 1 diabetes mellitus in children and adolescents with its complications, especially microvascular ones (retinopathy, nephropathy, and neuropathy) that affect the expectancy of their lives, besides imposing restrictions on their physical, emotional, and social functioning, adversely affecting their quality of life, in turn would lead to worsening of their compliance and adherence to the treatment with subsequent hazards on metabolic control, development, and progression of adverse diabetic complications that might cause multiple organ damage and impose more disease burden and impact the quality of life of the growing young diabetics and their families. The aim of the present study was to assess health-related quality of life of a group of Egyptian children and adolescents with type 1 diabetes in addition to investigate the relation of microvascular complications and other sociodemographic and clinical indicators to their quality of life. This case-control study was executed in the Diabetes Clinic and in the outpatient clinics, Children’s Hospital, Ain Shams University, and Medical Research Centre of Excellence clinics, June 2013–June 2015, which was carried out on 60 children and adolescents with type 1 diabetes mellitus, with ages ranged between (8-18) years compared with 60 apparently healthy children matched as regards their age, sex, and socioeconomic status. No significant differences between studied diabetic and healthy children (8–12 years) (total generic health-related quality of life score mean = (77.05 ± 14.58 vs. 79.32 ± 11.15, respectively). But there was a significant decrease for studied diabetic adolescents (13–18 years) compared to healthy peers (64.37 ± 14.54 vs. 74.74 ± 13.34, respectively). Microvascular complications impacted the health-related quality of life of type 1 diabetic children and adolescents, the most worsen effect was associated with neuropathy (p < 0.001). Statistically significant negative correlations were found between health-related quality of life domains with all metabolic control parameters, and the strongest correlation was between treatment adherence scale with HbA1c% (r = − 0.941, p ˂ 0.001). Health-related quality of life of the studied diabetic children and adolescents was negatively affected by the development of microvascular complications, especially diabetic neuropathy, while positively affected by achieving good metabolic control (HbA1c < 8%).

Effectiveness of two concentrations 12% versus 38% of silver diamine fluoride in arresting cavitated dentin caries among children: a systematic review

This systematic review was performed to compare the effectiveness of two concentrations (12% versus 38%) of silver diamine fluoride (SDF) in arresting cavitated dentin caries among children. A search of randomized clinical trials was performed in six databases: PubMed, Scopus, the Latin American and Caribbean Health Sciences Literature database (LILACS), the Cochrane Library, Turning Research Into Practice (TRIP) database (Trip medical database), and National Institute for Health and Care Excellence (NICE Evidence Search) database. A manual search was performed on the reference lists of all primary studies for additional relevant publications. No restrictions on publication date or languages were involved. Full-text versions of the papers that appeared to meet the inclusion criteria were retrieved for further assessment and data extraction. The initial search identified a total of 373 articles; three publications were found to meet the inclusion criteria. Risk of bias assessment was performed. The three publications agreed that the 38% SDF had a higher chance of arresting dentin caries in primary teeth than the 12% SDF concentration. Further trials are needed for establishing a suitable protocol in the view that the higher the SDF concentration and frequency of application, the higher the incidence of black staining.

Value of magnetic resonance spectroscopy in assessment of adnexal lesions

The purpose of this study is to investigate the role of proton MR spectroscopy (1H-MRS) in the characterization and diagnosis of ovarian lesions. From October 2015 to October 2017, a total of 57 female patients (65 adnexal lesions; 8 cases were bilateral) were included. The examined lesions were classified according to their histopathological findings, (37 (57%) benign lesions, 4 (6%) borderline lesions, and 24 (37%) malignant lesions). The mean choline/creatinine (CHO/Cr) ratio was 1.29 ± 0.98 SD for malignant lesions, while the mean value in borderline lesions was 0.63 ± 0.15 SD, and the mean value for the benign lesions was 0.65 ± 0.34. Therefore, the mean CHO/Cr ratio was much higher in malignant than in benign lesions, which was statistically significant (P ≤ 0.001) as well as between the borderline and invasive lesions (P = 0.05), but not between the benign and borderline lesions. The diagnostic performance of conventional MRI in diagnosing adnexal lesions was 100%, specificity was 76%, and accuracy was 86%. However, MRS individual diagnostic performances are the following: sensitivity 89%, specificity, and 100% with an accuracy of 95%. MRS proved to be an accurate and efficient method for the analysis of adnexal lesions and in differentiation between benign and malignant tumors.

Hepatic sclerosing hemangioma mimics hepatic malignancies: a case report and multidisciplinary approach

BackgroundHepatic sclerosing hemangiomas (HSH) are rare benign vascular tumors that mimic radiologically hepatic malignancies. HSH is characterized by extensive fibrosis and hyalinosis as a result of degeneration and thrombosis. Pre-operative diagnosis is very difficult and most of the cases undergo surgical resections.Case presentationA 65 years old, hepatitis C virus-infected female presented by an accidentally discovered hepatic focal lesion. Magnetic resonance imaging (MRI) showed a T2 hyperintense mass displaying peripheral enhancement in porto-venous phase. The patient had a simultaneous typical hepatic hemangioma and multiple vertebral bodies’ hemangiomata. Tissue-guided biopsy revealed a densely sclerotic stroma containing vascular spaces with occasional obliteration of the lumen. Immunohistochemical staining was performed for Pan CK, CD34, SMA, VEGF, and c-Kit which confirmed the vascular nature of neoplasm and the involuting phase of hemangioma development. The patient was reassured and recommended for a regular radiological follow-up to reassess the lesion size.ConclusionThe definitive preoperative diagnosis of HSH is still problematic. However, the awareness of surgeons by this entity, peripheral enhancement in porto-venous phase on dynamic MRI, the presence of simultaneous typical hepatic hemangioma in the absence of cancer history could raise suspicion for HSH. Liver biopsy is still the gold standard in approaching the accurate diagnosis.

Ocular Manifestations of Rheumatoid Arthritis and Complications of Hydroxychloroquine Treatment

Background: Rheumatoid arthritis (RA) is the most common autoimmune disease. Ocular manifestations of RA vary and are mainly keratoconjunctivitis sicca, episcleritis, scleritis and keratitis. Antimalarial drugs [hydroxychloroquine (HCQ) and chloroquine (CQ)] have been used for the treatment of RA. Objective: The aim of this study was to study the ocular manifestations of rheumatoid arthritis and the complications of the use of hydroxychloroquine in treatment. Patients and methods: A prospective study that was conducted at Al-Zahraa University Hospital. The study included a total of 80 eyes of 40 patients. Patients were divided into two groups: Group (1) 20 RA patients not using HCQ treatment and group (2) 20 RA patients using HCQ treatment. All patients underwent complete ophthalmic examination including SD-OCT. Results: the most ocular manifestations found in patients were keratoconjunctivitis sicca (KCS) 93.8%, scleritis and episcleritis 2.5%, acute anterior uveitis (AAU) and sclerosing keratitis 1.3%. Regarding SD-OCT finding comparing between the two groups, we found signs of early HCQ retinopathy in patients of group 2 in the form of parafoveal and perifoveal thining compared to group 1. Conclusion: RA is associated with many extra-articular manifestations, HCQ and CQ used in treatment of RA have significant efficacy and safety, but with long duration of using can cause retinopathy, and follow up of patients is necessary to detect early retinopathy.

Descriptive analysis of effect of uptake of comprehensive antenatal care services on neonatal mortality, Kenya

Background Antenatal care services help decrease neonatal mortality. Laboratory profiling is a highly recommended part of antenatal care services, but it is often neglected. Aims To explore the importance of comprehensive antenatal care services in reducing neonatal mortality among births at Moyale Sub-County Referral Hospital in Kenya. Methods A retrospective review was conducted of maternity records of all women aged 15 years old or more who gave birth at Moyale Sub-County Referral Hospital between June 2014 and May 2015. Stillbirths were excluded from the analysis. Data were entered into Microsoft Excel and descriptive statistics calculated. A total of 1062 women were included in the study, with mean age of 24 ± 9.1 years. Of these, 11% had no antenatal care visits, 2% were HIV-positive, and all lived within 10 km of Moyale Sub-County Referral Hospital. Findings Children of women who had no antenatal care visits were 2.7 times more likely to die within 28 days of birth compared to children born to women who had 1 antenatal care visit, and 8.5 times more likely to die compared to women who had at least three antenatal care visits. Conclusions Antenatal care profiling helps reduce neonatal mortality by capturing early diagnosis of preventable conditions that affect birth outcomes.