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Background: The existence of β3 receptors in the bladder and ureter was documented in many studies on animals and humans, it was documented that relaxation of the lower ureteral segment is achieved by the stimulation of these receptors. Our aim was to assess the efficacy and safety of mirabegron as a medical expulsive therapy (MET) for distal ureteral stones in comparison with silodosin and placebo.Methods: One hundred eighty patients with distal ureteral stone of 5–10 mm size were included in our study. They were divided into three groups, and each one consisted of 60 patients. Group I was given silodosin 8 mg, group II mirabegron 50 mg and group III placebo once daily. The treatment was prescribed for all the cases till stone expulsion or a maximum duration of 4 weeks. Primary outcome was the stone expulsion rate (SER). While secondary outcomes were stone expulsion time, side effects of the used drugs, hospital visits number for pain, and amount of analgesic taken.Results: We found that the SER was significantly higher in silodosin than mirabegron and placebo groups (61%, 38.6%, and 36.7%, respectively) (p= 0.013). Also, the stone expulsion interval was significantly shorter in silodosin than mirabegron and control groups (p< 0.001). While hospital visits number for pain, and amount of analgesic taken were comparable. There was no difference between the studied medications in terms of the adverse effects except for retrograde ejaculation (silodosin = 63.3%, mirabegron = 0%, and placebo = 0%; p< 0.001).Conclusion: Mirabegron has no medical expulsive effect. While silodosin improves SER and stone expulsion time. However, retrograde ejaculation was its main side effect and occurred in 63.3% of the male patients. Therefore, more research is needed to discover a more tolerable MET.

The effect of regional analgesia on perioperative infectious complications remains unknown. We therefore tested the hypothesis that a composite of serious infections after colorectal surgery is less common in patients with regional analgesia than in those given Intravenous Patient-Controlled Analgesia (IV-PCA) with opiates.

The marine habitat is a pool of valuable microorganisms with novel metabolites and potential products for industrial applications due to the challenging environment and diversity of living things. It is a proposed source for various commercial enzymes, including the asparaginase enzyme. There is a dearth of marine research conducted off the coast of India, particularly regarding biotechnology and industrial applications. Currently, the available types of L-asparaginase have thermostability and allergy issues. This study isolated and identified microorganisms capable of producing L-asparaginase from Arattuvazhy Golden Beach and Veli Beach's marine water in Thiruvananthapuram, Kerala State. Eleven novel bacteria strains were identified, then identified at the molecular level using suitable primers, followed by sequencing and a phylogenetic tree. Three novel species were selected from the Bacillus genera to clone their asparaginase genes for their novelty. Bacillus zhangzhouensisB29 is not reported for the production of L-asparaginase or any other enzymes; also, L-asparaginase I from B. alititudinisand B. australimaris B28Aare not reported. The asparaginase genes (ansA and ansB) were cloned from three species except for ansB from B. australimaris B28A, in which the whole genome sequence was done to retrieve the sequence. Finally, ansB, which is expressed as L-asparaginase II, is identified using the annotated genome sequencing (WGS) of B. australimaris B28A, which is cloned and expressed in the bacterial system with a length of 1149 bp and a homo tetramer size unit of 41 kDa. The SDS-PAGE image and the sequencing verification of the cloned plasmid's open reading frame confirm the gene's in silico analyses. The present study confirms the need for further optimisation of culture conditions for the commercial application of the new L-asparaginase source isolated from India's southern marine zone.

Purpose:Chlamydia pneumoniaeis associated with human respiratory diseases. Few reports examined the involvement of this bacterium in community-acquired pneumonia (CAP) in Jordan. This study investigates for the first time the role of C. pneumoniaein the establishment of CAP among nationals residing the southern part of Jordan. Materials and Methods:Nasopharyngeal and sera samples were collected from 70 hospitalised CAP patients and 63 healthy controls from Al-Karak Governorate and examined using the microimmunofluorescence and polymerase chain reaction techniques. The overall prevalence of C. pneumoniaeinfection was estimated by detecting the chlamydial immunoglobulin G (IgG) antibodies at a titre of 1:16. Rate of acute infection was estimated by detecting chlamydial DNA in nasopharyngeal samples and IgG and IgM at titres of 1:512 and 1:16, respectively. Results:A higher overall seroprevalence of C. pneumoniaeIgG was detected in CAP patients than controls (44.3% vs. 30.2%). The rate of acute infection in the entire CAP patients, based on IgG titre of 1:512, was 7.14% compared to 1.58% in the controls. Approximately, three-fold increase in the rate of acute infection was observed in CAP cases, seropositive at IgG titre of 1:16, compared to seropositive controls (16.1% vs. 5.3%). Interestingly, chlamydial IgM antibodies were detectable in 27.1% compared to only 3.2% of the controls. The presence of chlamydial nucleic acids was confirmed in 40% of CAP patients and in 7.9% of controls. Conclusions:The present findings clearly suggest a role of C. pneumoniaein the aetiology of CAP in Southern Jordan. However, coinfections with other respiratory pathogens should not be excluded.

Contrast induced nephropathy (CIN) which is following the administration of radiographic contrast media in coronary intervention results in increased morbidity and mortality. Several prophylactic methods were done to prevent CIN post coronary intervention.

Patients with acute coronary syndrome (ACS) need to be risk stratified to deliver the most appropriate therapy. There is no appropriate score for early-risk stratification at the time of the first medical contact with ACS patients. Canada Acute Coronary Syndrome Risk Score (Canadian-ACS) is a new risk score for early prognostication in acute coronary syndromes. The aim of our study is to evaluate the accuracy and validity of Canadian-ACS risk score as a prognostic score for in-hospital risk stratification of patients with ACS, as compared to TIMI AND GRACE risk scores in the Egyptian patients.

Hypertension increases the risk of atrial fibrillation by about twofold. Micro-albuminuria is an independent predictor of cardiovascular morbidity and mortality in patients with atrial fibrillation.

The renin angiotensin system (RAS) is thought to be the body’s main vasoconstrictor system, with physiological effects mediated via the interaction of angiotensin II with angiotensin I receptors (the “classic” RAS model). However, since the discovery of the heptapeptide angiotensin 1–7 and the development of the concept of the “alternate” RAS system, with its ability to reduce arterial blood pressure, our understanding of this physiologic system has changed dramatically. In this review, we focus on the newly discovered functions of the RAS, particularly the potential clinical significance of these developments, especially in the realm of new pharmacologic interventions for treating cardiovascular disease.