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Abstract Objective This study was conducted to evaluate the antimicrobial efficacy and mechanical properties of two experimental self-disinfecting alginate preparations utilising two different antimicrobial agents; povidone-iodine and silver nanoparticles. Methods Alginate moulds were assigned into three groups. Additives-free control group, povidone-iodine-containing group, and silver nanoparticle-containing group. Discs from each group were obtained and assessed for their antimicrobial activities by the disc diffusion method against Staphylococcus aureus, Escherichia coli, and Candida albicans. For the elastic recovery analysis, each group was divided into 6 samples. Each sample was mixed according to its group specification and subjected to surface detail reproduction and elastic recovery according to ISO 1563:1990 specifications. All data were expressed as mean ± standard deviation for each group at the significance level of P

Abstract In this paper, we re-estimate the astrometric and photometric parameters of the young open star cluster King 18 based on Gaia Data Release 3 (DR3), Two Micron All-sky Survey (2MASS) and VRI CCD observations using the f/4.9 Newtonian focus of 74-inch telescope at Kottamia Astronomical Observatory (KAO) in Egypt. King 18 is a poorly studied open star cluster, for which new results are found in the current study. In order to estimate the membership and determine all the astrophysical parameters of the cluster, we have used data from Gaia DR3 and KAO. The center, cluster radius, radial density distribution, color-magnitude diagrams, distance, age, and reddening of King 18 are calculated. Also, the luminosity and mass functions, the total mass and the relaxation time of the cluster are estimated. The slope value of the mass function ( $$\alpha $$ α ) of King 18 is found to be 2.27± 0.17, which is comparable with Salpeter value. Our estimates for the average cluster age and the relaxation time are 224 ± 6.3 and 28.92 Myrs, respectively. This indicates that King 18 is dynamically stable and a relaxed cluster. The cluster distance modulus from Gaia, 2Mass and VRI observations has been determined to be 12.380 ± 1.320, 12.320 ± 0.107 and 12.280 ± 0.290 mag respectively, which corresponds to distances of 2992.26, 2910.72 and 2857.59 pc, respectively. These results are in good agreement within the error. Moreover the color excesses E(V–I), E(J– $$\hbox {K}_s$$ K s ) and E( $$\hbox {G}_{{BP}}$$ G BP – $$\hbox {G}_{{RP}}$$ G RP ) are 0.850 ± 0.087, 0.380 ± 0.091 and 0.980 ± 0.130 respectively. Finally, the proper motions ( $$\mu _{\alpha }$$ μ α cos $$\delta $$ δ , $$\mu _{\delta }$$ μ δ ), and parallaxes ( $$\varpi $$ ϖ ) are $$-2.603 \pm 0.018$$ - 2.603 ± 0.018 , $$-2.106 \pm 0.013$$ - 2.106 ± 0.013 and 0.324 ± 0.040, respectively.

Abstract Background The ineffectiveness of treatments for infections caused by biofilm-producing pathogens and human carcinoma presents considerable challenges for global public health organizations. To tackle this issue, our study focused on exploring the potential of synthesizing new complexes of Co(II), Cu(II), Ni(II), and Zn(II) with sorbic acid to enhance its antibacterial, antibiofilm, and anticancer properties. Methods Four novel complexes were synthesized as solid phases by reacting sorbic acid with Co(II), Cu(II), Ni(II), and Zn(II). These complexes were characterized by various technique, including infrared spectra, UV–Visible spectroscopy, proton nuclear magnetic resonance (1H NMR), and thermal analysis techniques, including thermogravimetry (TG). Results The data acquired from all investigated chemical characterization methods confirmed the chemical structure of the sorbate metal complexes. These complexes exhibited antibacterial and antibiofilm properties against both Gram-positive and Gram-negative bacteria. Furthermore, these complexes enhanced the antibacterial effects of commonly used antibiotics, such as gentamicin and imipenem, with fractional inhibitory concentration (FIC) indices ≤ 0.5. Notably, the Cu(II) complex displayed the most potent antibacterial and antibiofilm activities, with minimum inhibitory concentration (MIC) values of 312.5 µg/mL and 625.0 µg/mL for Bacillus cereus and Escherichia coli, respectively. Additionally, in vitro assays using the methyl thiazolyl tetrazolium (MTT) method showed inhibitory effects on the growth of the human colon carcinoma cell line (HCT-116 cells) following treatment with the investigated metal complexes. The IC50 values for Co(II), Cu(II), Zn(II), and Ni(II) were 3230 µg/mL, 2110 µg/mL, 3730 µg/mL, and 2240 µg/mL, respectively. Conclusion Our findings offer potential for pharmaceutical companies to explore the development of novel combinations involving traditional antibiotics or anticancer drugs with sorbate copper complex.

Abstract Background Diabetic kidney disease (DKD) is one of the most serious microvascular complications of diabetes mellitus (DM) and the leading cause of chronic kidney disease (CKD) worldwide. Since obesity and type 2 DM (T2DM) are considered as inflammatory conditions, thus reducing their accompanied systemic inflammation may lessen their complications. Sestrin 2 belongs to a group of stress induced proteins which are produced in response to oxidative stress, inflammation and DNA damage. Betatrophin; a hormone that stimulates the growth, proliferation and mass expansion of pancreatic beta-cells and improves glucose tolerance. The objective of the study was to evaluate levels of serum Sestrin 2 and betatrophin in patients with different stages of diabetic nephropathy (DN)) and compare results with healthy control. Methods This cross sectional study was carried out on 60 patients above 18 years old, recruited from Tanta University hospitals out patients clinics and 20 apparently healthy individuals of matched sex and age as a control group. Participants were divided into two groups: group I: 20 normal subjects as control group and group II: 60 patients with type 2 DM,. further subdivided in to three equal groups: group 1IIA(20 patients) with normo-albuminuria (ACR 300 mg/g). They were subjected to detailed history taking, careful clinical examination and laboratory investigations including blood urea, serum creatinine, estimated glomerular filtration rate (eGFR), urinary albumin creatinine ratio, and specific laboratory tests for Sestrin 2 and Betatrophin by using ELISA technique. Results Serum Sestrin 2 significantly decreased, while serum betatrophin level significantly increased in macroalbuminuric group compared to control and other 2 diabetic groups (P value 98.25 ng/ml with sensitivity 98%, specificity 82%. Serum betatrophin positively correlated with age, fasting, 2 h postprandial, BMI, triglyceride, total cholesterol, serum creatinine, blood urea, UACR, and negatively correlated with eGFR and serum albumin. Serum Sestrin 2 positively correlated with serum albumin. BMI, serum urea, UACR and serum albumin. Serum betatrophin are found to be risk factors or predictors for diabetic nephropathy. Conclusions Patients with DN, particularly the macroalbuminuria group, had a significant increase in betatrophin levels and a significant decrease in serum Sestrin 2 level. The function of Sestrin 2 is compromised in DN, and restoring it can reverse a series of molecular alterations with subsequent improvement of the renal functions, albuminuria and structural damage.

IntroductionDespite years of efforts to develop new antibiotics for eradicating multidrug-resistant (MDR) and multi-virulent Methicillin-Resistant Staphylococcus aureus (MRSA) and Vancomycin-Resistant Staphylococcus aureus (VRSA) infections, treatment failures and poor prognoses in most cases have been common. Therefore, there is an urgent need for new therapeutic approaches targeting virulence arrays. Our aim is to discover new anti-virulence therapies targeting MRSA and VRSA virulence arrays.MethodologyWe employed phenotypic, molecular docking, and genetic studies to screen for anti-virulence activities among selected promising compounds: Coumarin, Simvastatin, and Ibuprofen.ResultsWe found that nearly all detected MRSA and VRSA strains exhibited MDR and multi-virulent profiles. The molecular docking results aligned with the phenotypic and genetic assessments of virulence production. Biofilm and hemolysin productions were inhibited, and all virulence genes were downregulated upon treatment with sub-minimum inhibitory concentration (sub-MIC) of these promising compounds. Ibuprofen was the most active compound, exhibiting the highest inhibition and downregulation of virulence gene products. Moreover, in vivo and histopathological studies confirmed these results. Interestingly, we observed a significant decrease in wound area and improvements in re-epithelialization and tissue organization in the Ibuprofen and antimicrobial treated group compared with the group treated with antimicrobial alone. These findings support the idea that a combination of Ibuprofen and antimicrobial drugs may offer a promising new therapy for MRSA and VRSA infections.ConclusionWe hope that our findings can be implemented in clinical practice to assist physicians in making the most suitable treatment decisions.

Abstract Globally, millions of cubic meters of dye-contaminated wastewater are generated annually from the textile industry. Discharging the dye-contaminated wastewater into natural water streams is detrimental to the ecosystem and human health. Wastewater bioremediation is considered a practical solution for converting wastewater into value-added water for safe reuse especially in irrigation. The present study investigated the immobilization of highly stable spore laccase enzyme of Bacillus amyloliquefaciens A1 by entrapment and adsorption techniques. Based on the results, agarose gel was the most efficient support with 94% immobilization yield. Optimum temperature of immobilized enzyme was at 60 ℃ with complete thermal stability for 120 min. The maximum activity of immobilized enzyme was at pH 6–7 and retained 91% of its activity after 24 h incubation. It showed 100% storage stability after 8 weeks which was higher than that of un-immobilized enzyme (4 weeks). The enzyme activity was nearly stable after 8 consecutive cycles of reuse. Decolorization of 8 textile dyes was studied using the immobilized enzyme. Crystal violet, direct red 81 and acid black 24 were efficiently decolorized (94.5, 77.4, and 68.8%, respectively) within 24 h in the first cycle. Reusability of immobilized enzyme showed 74.6, 53.5, and 51.8% decolorization of the same dyes in the same order after the second cycle. Immobilized spore laccase-treated dye water was used to irrigate lentil seeds and showed germination index about 73% compared to 10.8% for untreated one indicating very low toxicity of the treated dye water.

Islanded microgrids, powered by renewable energy sources, offer a sustainable electricity solution for remote areas. However, maintaining frequency stability in these systems remains a challenge due to the intermittent nature of renewables. This research proposes an approach to enhance microgrid stability by integrating a green hydrogen energy storage system (GHESS) and employing advanced AI-based control strategies. The GHESS plays a pivotal role in storing excess renewable energy as hydrogen and then converting it back to electricity when needed, reducing reliance on traditional backup generators. To optimize microgrid performance, a hybrid single-neuron PID (SNPID) controller, augmented by machine learning techniques, is developed and compared against conventional proportional, integral, and derivative PID and fuzzy self-tuning PID (FSTPID) controllers. The system’s performance was evaluated using four realistic scenarios. In all cases, the SNPID controller significantly outperformed the existing options. It achieved a 58% reduction in frequency fluctuations compared to the fuzzy self-tuning PID (FSTPID) controller and an impressive 87% reduction compared to the traditional PID controller. The Simulation results underscore the SNPID controller’s exceptional performance in frequency stability, emphasizing the transformative potential of AI for microgrid management.

4D millimeter-wave radar can work in harsh weather conditions such as fog and snow, and measure the position and radial Doppler velocity of objects in three-dimensional space. Some existing methods perform positioning by fusing 3D velocity or point cloud matching information estimated by 4D radar with IMU information. However, the sparsity of radar point clouds and the interference of large amount of noise lead to low accuracy of odometry, and most of the existing work cannot achieve the global consistent mapping with radar point clouds. In this paper, a 4D radar/IMU/GNSS localization and mapping method, G-iRIOM, is proposed. We tightly coupled IMU measurement, Doppler observation information and point cloud matching information from 4D radar by iterative extended Kalman filtering (iEKF) method, and introduced GNSS RTK and loop closure information as global observation to correct the positioning drift of the odometry. The experimental results show that the tightly coupled Doppler velocity information can effectively improve the control of the pose on the local point cloud position, thus enhancing the mapping accuracy. Meanwhile, the introduction of GNSS and loop closure information can significantly improve the positioning accuracy of 4D radar odometry as a kind of global observation, and achieve global consistent mapping of large-scale outdoor scenes based on 4D radar point clouds.

Abstract Background The severity of chronic hepatitis C and susceptibility to hepatocellular carcinoma (HCC) are associated with genetic variations within vitamin D receptor (VDR) in several populations. This study aims to determine the significance of the VDRs (rs2228570, rs3782905, rs11568820) and DBP (rs7041) for the susceptibility to HCC in Egyptian patients with chronic HCV infection and their effect on the progression of liver cirrhosis to carcinogenesis. Methods Single nucleotide polymorphisms (SNPs) VDR (rs2228570, rs3782905), and DBP rs7041 were genotyped using restriction fragment length-PCR (RFLP-PCR) technique and VDR rs11568820 was genotyped using single strand polymorphism PCR (SSP PCR). These SNPs genotypes, haplotypes and linkage disequilibrium analyses were examined in 299 Egyptian individuals (100 HCV-cirrhotic patients, 99 HCC- HCV patients, and 100 healthy controls). Result The VDR rs2228570 CC genotype, VDR rs3782905 GC and CC genotypes, and DBP rs7041 GG genotype are significantly higher in HCC. It is noteworthy that, VDR rs3782905 CC and DBP rs7041 TG genotypes are higher in HCV induced liver cirrhosis than with HCC progression in HCV infected patients. Furthermore, among patients, the relationship between these SNPs and smoking status, gender, and HCC susceptibility was reported. Conclusion Among the four investigated SNPs, there are associations between VDR rs3782905 and DBP rs7041 and the HCC progression in Egyptian patients chronically infected with HCV. These SNPs are considered as risk factors in HCV induced liver cirrhosis and HCC. The combinations of these SNPs with smoking status and gender are statistically linked to a high risk of HCC. Future research with a larger sample size of subjects with HCV infection is advised, because chronic liver disease induced by HCV infection is the primary cause of HCC in Egypt. We recommend screening of these SNPs for prediction of LC and HCC development in HCV infected patients, which may improve the used therapeutic protocol. These results suggest that VDR polymorphisms may be potential determinants for HCC susceptibility in Egyptian HCV patients.

BackgroundP. aeruginosa, a significant bacterium, can cause severe illness and resistance to antibiotics. Quorum sensing (QS) systems regulate virulence factors production. Targeting QS could reduce bacteria pathogenicity and prevent antibiotic resistance. Cruciferous vegetables contain sulforaphane, known for its anti-inflammatory, antioxidant, anticancer, and antimicrobial properties.AimWe aimed to examine the inhibitory influences of sulforaphane, at a sub-inhibitory concentration (¼ minimum inhibitory concentration, MIC), on virulence and QS in P. aeruginosa.Materials and methodsThe sulforaphane’s anti-virulence actions at sub-inhibitory concentrations were explored in vitro and in vivo. A sub-MIC concentration of sulforaphane was combined with anti-pseudomonal drugs, and the results of this combination were assessed. The virtual affinity of sulforaphane for the receptors of QS was studied, and its effect on the expression of QS genes was quantified.ResultsSulforaphane significantly decreased the biofilm formation, motility, ability to withstand oxidative stress, and the synthesis of virulence extracellular enzymes such as proteases, hemolysins, and elastase, as well as other virulence factors like pyocyanin. In addition, sulforaphane lessened the severity of P. aeruginosa infection in mice. Sulforaphane reduced the antipseudomonal antibiotics’ MICs when used together, resulting in synergistic effects. The observed anti-virulence impacts were attributed to the ability of sulforaphane to inhibit QS via suppressing the QS genes’ expression.ConclusionSulforaphane shows promise as a potent anti-virulence and anti-QS agent that can be used alongside conventional antimicrobials to manage severe infections effectively. Furthermore, this study paves the way for further investigation of sulforaphane and similar structures as pharmacophores for anti-QS candidates.

Abstract Microbial degradation of synthetic dyes is considered a promising green dye detoxification, cost-effective and eco-friendly approach. A detailed study on the decolorization and degradation of malachite green dye (MG) using a newly isolated Pseudomonas plecoglossicide MG2 was carried out. Optimization of MG biodegradation by the tested organism was investigated by using a UV–Vis spectrophotometer and the resultant degraded products were analyzed by liquid chromatography–mass spectrometry and FTIR. Also, the cytotoxicity of MG degraded products was studied on a human normal retina cell line. The optimum conditions for the significant maximum decolorization of MG dye (90–93%) by the tested organism were pH 6–7, inoculum size 4–6%, and incubation temperature 30–35 °C, under static and aerobic conditions. The performance of Pseudomonas plecoglossicide MG2 grown culture in the bioreactors using simulated wastewater was assessed. MG degradation (99% at 100 and 150 mg MG/l at an optimal pH) and COD removal (95.95%) by using Pseudomonas plecoglossicide MG2 culture were the best in the tested culture bioreactor in comparison with that in activated sludge or tested culture-activated sludge bioreactors.The FTIR spectrum of the biodegraded MG displayed significant spectral changes, especially in the fingerprint region 1500–500 as well as disappearance of some peaks and appearance of new peaks. Twelve degradation intermediates were identified by LC–MS. They were desmalachite green, didesmalachite green, tetradesmalachite green, 4-(diphenylmethyl)aniline, malachite green carbinol, bis[4-(dimethylamino)phenyl]methanone, [4-(dimethylamino)phenyl][4-(methyl-amino)phenyl]methanone, bis[4-(methylamino)phenyl]methanone, (4-amino- phenyl)[4-(methylamino)phenyl]methanone, bis(4-amino phenyl)methanone, (4-amino phenyl)methanone, and 4-(dimathylamino)benzaldehyde. According to LC–MS and FTIR data, two pathways for MG degradation by using Pseudomonas plecoglossicide MG2 were proposed. MG showed cytotoxicity to human normal retina cell line with LC50 of 28.9 µg/ml and LC90 at 79.7 µg/ml. On the other hand, MG bio-degraded products showed no toxicity to the tested cell line. Finally, this study proved that Pseudomonas plecoglossicide MG2 could be used as an efficient, renewable, eco-friendly, sustainable and cost-effective biotechnology tool for the treatment of dye wastewater effluent.

Abstract Background Knowledge of the frequency of precipitating factors for acute heart failure (AHF) is important (either new-onset heart failure [NOHF] or worsening heart failure [WHF]), as this can guide strategies for prevention and treatment. Most data come only from Western Europe and North America; nevertheless, geographic differences do exist. We set out to study the prevalence of precipitating factors of AHF and their connection to patient characteristics and in-hospital and long-term mortality in patients from Egypt hospitalized for decompensated HF. Using the ESC-HF-LT Registry which is a prospective, multicenter, observational study of patients confessed to cardiology centers in the nations of Europe and the Mediterranean, patients presenting with AHF were recruited from 20 centers all over Egypt. Enrolling physicians were requested to report possible precipitants from among several predefined reasons. Results We included 1515 patients (mean age 60 ± 12 years, 69% males). The mean LVEF was 38 ± 11%. Seventy-seven percent of the total population had HFrEF, 9.8% had HFmrEF, and 13.3% had HFpEF. The commonly reported precipitating factors for AHF hospitalization among study population were as follows (in decreasing order of frequency): infection in 30.3% of patients, acute coronary syndrome/myocardial ischemia (ACS/MI) in 26%, anemia in 24.3%, uncontrolled hypertension in 24.2%, atrial fibrillation (AF) in 18.3%, renal dysfunction in 14.6%, and non-compliance in 6.5% of patients. HFpEF patients had significantly higher rates of AF, uncontrolled hypertension, and anemia as precipitants for acute decompensation. ACS/MI were significantly more frequent in patients with HFmrEF. WHF patients had significantly higher rates of infection and non-compliance, whereas new-onset HF patients showed significantly higher rates of ACS/MI and uncontrolled hypertension. One-year follow-up revealed that patients with HFrEF had a significantly higher rate of mortality compared to patients with HFmrEF and HFpEF (28.3%, 19.5, and 19.4%, P = 0.004). Patients with WHF had a significantly higher rates of 1-year mortality when compared to those with NOHF (30.0% vs. 20.3%, P

Abstract Aims Both S100A4 and Glypican-3 have been known to be engaged in HCC development and progression. This study aimed to evaluate both S100A4 and GPC3 expression in HCC tissues as a prognostic markers. Methods Tissues from 70 patients of HCC in cirrhotic HCV patients were evaluated by immunohistochemistry using antibodies against SA100A4 and GPC3 and compared with tumor-adjacent tissue (controls). All cases were followed for 40 months. Results GPC3 was more expressed in HCC (79%) than S100A4 (21%). S100A4 was more significantly expressed in cases showing metastasis, microscopic vascular emboli, necrosis, and grade III tumors. There was no relationship between overall survival and both S100A4 and GPC3. The only significant independent predictor for recurrence was decompensation (OR 3.037), while metastasis was significantly predicted by S100A4 expression (OR 9.63) and necrosis (OR 8.33). Conclusion S100A4 might be used as a prognostic marker for HCC, while GPC3 is a reliable marker of HCC diagnosis.

Abstract Background Intravascular imaging modalities such as intravascular ultrasound (IVUS) and, more recently, optical coherence tomography (OCT) improved the visualization of coronary anatomy and plaque pathology. We aimed to compare the procedural and short-term outcomes between IVUS-guided and OCT-guided percutaneous coronary interventions (PCIs) in patients with acute coronary syndrome (ACS). Methods In the present retrospective study, we reviewed the data of 50 patients who had IVUS-guided PCI and 50 patients who had OCT-guided PCI for ACS between January 2020 and June 2021. Intravascular imaging was done before and after stenting. Both groups were compared in terms of minimal luminal area (MLA), stent dimensions, final minimal stent area (MSA) and stent expansion as well as negative angiographic outcomes. Patients were followed for six months to record major adverse cardiac events (MACE). Results The patients’ mean age was 57 ± 13 years with male predominance (78%). The radiation time and dose were significantly higher among IVUS group. Pre-stenting MLA was significantly higher in IVUS group (2.63 mm vs. 2.22 mm in OCT, P = 0.013). Stent expansion was significantly higher among OCT group (97% vs. 93% in IVUS group, P = 0.001) with no significant difference between both groups regarding MSA [mm2] (8.88 ± 2.87 in IVUS vs. 8.1 ± 2.76 in OCT, P = 0.169). No significant difference between both groups was noted regarding contrast volume, edge dissection, tissue prolapse, and no reflow. The rates of six-month MACE were significantly higher in the IVUS group. Conclusions OCT-guided PCI in ACS is safe and is associated with similar MSA to that of IVUS-guided PCI. Future randomized trials are needed to confirm these findings. Graphical Abstract

The taxonomic and functional diversities of macroinvertebrates are a critical indicator of ecosystem health. This study focuses on the taxonomic and functional diversities of the assemblage structure of macroinvertebrates in the Ibrahimia Canal, Egypt. They were compared across two different substrate habitats: sediment-associated and macrophytes-associated habitats. Significant variations in the taxonomic and biological trait community composition in the two substrate habitats were recorded, with high taxa abundance in sediment substrate and increased diversity in macrophyte substrate. In sediment substrates, burrow dweller and collector-filterer taxa were the main characteristics, while tube dweller and collector-gatherer were the main traits of macrophytes substrate. The taxonomic and functional indices tended to increase from sediment to macrophytes substrate; however, there was an increase in Rao’s quadratic entropy index (RaoQ) for sediment substrate habitat. Redundancy analyses explained the association between environmental factors and macroinvertebrate taxa and traits. Total suspended solids, dissolved oxygen, chemical demand oxygen, and phosphate were the key environmental drivers of the taxonomic and functional diversities of macroinvertebrates. Integration between the approaches to taxonomic and functional diversity is recommended to give insight into explaining and managing the freshwater ecosystem.

Background: The evolution and springing up of carbapenemase-producingEnterobacteriaceae (CPE) threatens worldwide health. The capability of carbapenemases to degrade all β-lactam antibiotics leads to less antibiotics retaining activity against infections caused by CPE that are associated with high mortality and bad prognosis. There is an urgent need to define robust standardized screening methods for the effective detection of CPE in order to control their spread. This study aimed to detect the efficiency of Chromatic TM CPE medium in identifying CRE directly from ICU clinical samples. Methods: A Cross section study was conducted at intensive care units and Medical Microbiology and Immunology laboratory, Faculty of medicine, Ain Shams university. The sample was directly inoculated on CRE chromagar plate and incubated at 35°C aerobically. Isolation and identification of CPE was performed according to Manual of Clinical Microbiology 2019 then antimicrobial susceptibility test by Kirby-Baur disc diffusion. The sensitivity and specificity of CRE screening by CRE chromogenic media were detected using Modified carbapenemase inactivation method (mCIM) as the standard method. Results: One hundred and fifty-eight isolates were obtained from hospitalized ICU patients in Ain shams university hospital between April to November 2022. There were different types of samples, the most common one was sputum. Among 71 isolates grew on blood and MacConkey agar media, 59 (83.15%) showed growth on chromogenic media while 12 (16.9%) showed no growth on chromogenic media. Fifty-four (76.1%) showed MDR Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter baumannii. Among 54 MDR isolates, 50 (92.6%) were positive carbapenemase production, while 4 (7.4%) were negative carbapenemase production using mCIM test as confirmatory test. The sensitivity of chromogenic media was 98%, specificity was 50% in all isolates and the accuracy of the test was 94.4%. While the sensitivity of chromogenic media in all Enterobacteriaceae was 96.9%, specificity was 33.3%. Conclusion: This study revealed that CRE chromogenic is highly sensitive in the screening of CRE detection. It efficiently saves more time in identifying CRE as compared to mCIM method. The use of a single chromogenic medium can reduce the cost of sample processing and be an effective tool for rapid detection of CRE. Accurate and fast detection of patients colonized by CPEs is clinically important in applying proper infection control precautions.

Abstract Background Till the moment of this document writing, no Egyptian consensus is there to guide selection of additional antithrombotic in stable patients with established CVD. Despite use of lifestyle measures and statins, those patients with established CVD still face a considerable burden of residual risk. Main body With the evolvement of evidence-based medicine, there have been a lot of recommendations to use additional antithrombotic medications to maximize protection for those patients. Accordingly, the Egyptian Society of Cardiology working group of thrombosis and prevention took the responsibility of providing an expert consensus on the current recommendations for using antithrombotic medications to maximize protection in stable patients with established CVD. For stable patients with established CVD, in addition to proper lifestyle measures and appropriate dose statins, we recommend long-term aspirin therapy. In patients who are unable to take aspirin and in those with a history of gastrointestinal bleeding, clopidogrel is a reasonable alternative. Conclusions For some stable atherosclerotic CVD patients who are at high risk of cardiovascular events and at low risk for bleeding, a regimen of rivaroxaban and aspirin might be taken into consideration.