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Background: The carbapenem-resistant Klebsiella pneumoniae poses a serious threat to public health because carbapenems are used as a final resort to treat K. pneumoniae-mediated infections in humans. Methods: Samples were collected from various clinical specimens including skin swabs, anal swabs, wound swabs, oral swabs, and sputum by the standard method and K. pneumoniae strains were isolated. Biofilm-forming characters were determined. The antibiotic resistance pattern was analyzed by the Kirby–Bauer disk diffusion method. Carbapenem resistance properties were tested using the imipenem and meropenem antibiotics. The carbapenemase genes (blaKPC and blaNDM) were determined. Results: A total of 11 cephalosporin-resistant K. pneumoniae (CRKP) strains were isolated from the samples. The screened CRKP strains exhibited multi-drug resistance and non-susceptible to imipenem, ceftazidime, piperacillin, ceftriaxone, cefazolin, ampicillin, aztreonam, and cefotetan antibiotics. A total of 79.4 % K. pneumoniae isolates showed positive results on String-forming test. About 82.1 % of isolates showed mucoid colonies and 59 % of K. pneumoniae strains formed biofilm (p

Abstract Background Pediatric rhegmatogenous retinal detachments (PRRDs) are complex, rare occurrences and are often related to trauma or congenital abnormalities. Children often do not recognize or report symptoms of retinal detachment. Thus at presentation, PRRD is typically advanced often with macular involvement, proliferative vitreoretinopathy (PVR), chronic duration, and poor visual acuity. Because 5-FU and LMWH are effective in different aspects in the PVR process, it was believed that a syngergistic approach to the prevention of PVR would be advantageous. Methods After informed consent, children under 14 years of age with high-risk PRRD underwent pars plana vitrectomy and silicone oil injection with scleral buckle divided into 2 groups in prospective randomized trial. Group A received intraoperative infusion of 5-FU (200 µg/ml) and LMWH (5 IU/ml), group B received infusion of normal saline. Primary outcome was occurrence of recurrent PRRD within 12 weeks, secondary outcomes were occurrence of PVR, best corrected visual acuity (BCVA), number and timing of secondary procedures within 12 weeks. Results The study included 42 eyes of 41 patients, 21 in group A and 21 in group B, the duration of PRRD ranged from 0.5 to 7 months in group A and 0.25-5 months in group B.The rate of recurrent PRRD was higher in group B 33% compared to 19% in group A (p = 0.292). The mean timing of occurrence of recurrent PRRD was 9.5 ± 5 weeks in group A compared to 2.86 ± 2.41 weeks in group B (p = 0.042), more patients in group B ended up with more advanced PVR (p = 0.038), BCVA was hand movement (HM) only in all cases preoperatively and improved to HM-0.3 Snellen in group A compared to light perception (PL)-0.1Snellen in group B (p = 0.035), there was no difference in any of secondary procedures but with later timing in group A 9.71 ± 3.73 weeks than in group B 4.0 ± 2.83 weeks (p = 0.042). Conclusion This study concluded that the use of the 5-FU and LMWH combination in high risk PRRD resulted in lower rate of postoperative PVR, later recurrence of PRRD and better final BCVA. Trial registration number Registry: clinicaltrials.gov PRS NCT06166914 date of initial release 4/12/2023. Unique Protocol ID: 9,163,209 date 21/10/2021. Retrospectively registered

Users’ privacy is vulnerable at all stages of the deep learning process. Sensitive information of users may be disclosed during data collection, during training, or even after releasing the trained learning model. Differential privacy (DP) is one of the main approaches proven to ensure strong privacy protection in data analysis. DP protects the users’ privacy by adding noise to the original dataset or the learning parameters. Thus, an attacker could not retrieve the sensitive information of an individual involved in the training dataset. In this survey paper, we analyze and present the main ideas based on DP to guarantee users’ privacy in deep and federated learning. In addition, we illustrate all types of probability distributions that satisfy the DP mechanism, with their properties and use cases. Furthermore, we bridge the gap in the literature by providing a comprehensive overview of the different variants of DP, highlighting their advantages and limitations. Our study reveals the gap between theory and application, accuracy, and robustness of DP. Finally, we provide several open problems and future research directions.

Enhancing the privacy of machine learning (ML) algorithms has become crucial with the presence of different types of attacks on AI applications. Continual learning (CL) is a branch of ML with the aim of learning a set of knowledge sequentially and continuously from a data stream. On the other hand, differential privacy (DP) has been extensively used to enhance the privacy of deep learning (DL) models. However, the task of adding DP to CL would be challenging, because on one hand the DP intrinsically adds some noise that reduce the utility, on the other hand the endless learning procedure of CL is a serious obstacle, resulting in the catastrophic forgetting (CF) of previous samples of ongoing stream. To be able to add DP to CL, we have proposed a methodology by which we cannot only strike a tradeoff between privacy and utility, but also mitigate the CF. The proposed solution presents a set of key features: (1) it guarantees theoretical privacy bounds via enforcing the DP principle; (2) we further incorporate a robust procedure into the proposed DP-CL scheme to hinder the CF; and (3) most importantly, it achieves practical continuous training for a CL process without running out of the available privacy budget. Through extensive empirical evaluation on benchmark datasets and analyses, we validate the efficacy of the proposed solution.

Background: Stroke is one of the leading causes of mortality and disability throughout the world. Recently, antioxidant therapies were attempted to reduce apoptotic cell death in cerebral ischemia animal model. Purpose: To study the neuroprotective properties of polyphenol derived from fungal endophyte analyzed on experimental Albino rat. Methods: Polyphenols producing endophytic fungi was initially isolated from the seeds of Moringa oleifera Lam. The endophytes were cultured in potato dextrose broth and the potent strain Simplicillium sp. ED7 produced maximum phenolic content (86.42 ± 5.3 mg GAE/g) than other fungi. Polyphenols were extracted with solvent and used for the determination of neuroprotective properties. Results: Isoflurane was used to induce stroke in Albino rat and treated polyphenols showed reduced neurological deficits and improved neuroprotective properties. The ischemic Albino rats treated with polyphenols restored memory loss. The increased dosage of polyphenol improved the biosynthesis of more antioxidant enzymes than lower dosages. Central artery occlusion evoked about 2.28-fold increase in reactive oxygen species in brain tissue and the generation of reactive oxygen species was decreased in polyphenol treated animal. Conclusion: Albino rats treated with different doses of polyphenol had decrease ROS amount than sham group. The elevated level of cytochrome revealed mitochondrial damage in stroke induced control Albino rat. After 24 h of reperfusion on Albino rat, upregulation of total p65 and phospho-p65 were determined. The present finding revealed that polyphenl has a neuroprotective property in ischemia and regulate metabolic enzymes and restore brain injury.

The main aim of this study is to analyze effective thrombolytic drugs of natural origin for the treatment of stroke. Thrombolytic activity of natural sources has been reported and active molecules have been isolated and characterized. In this study, a total of ten compounds from nature were selected for docking studies. Caesalpinine c, caesalpinine a, vanillylamine, terpinen-4-Ol, dihydrocapsaicin and 3-carene showed fibrinolytic properties on analysis with PASS server. The present work is based on computer aided molecular modeling and the strength of the ligand was validated using binding energy. Caesalpinine c exhibited good docking score and this compound showed potent thrombolytic activity than other compounds. The drug likeliness varied based on the chemical and physical properties of the ligand. Lipinski’s rule of five was accepted by all of the selected compounds. Pfizer’s rule, and GSK rule were accepted in caesalpinine C. The drug likeliness properties of the all ten selected ligands were accepted in most of the cases and few rejections were observed mostly in Golden Triangle rule. However further in vitro or in vivo trials are required to validate thrombolytic potential of caesalpinine c and vanillylamine.

Malaria infection, which results due to the parasitic protozoan Plasmodium, has several known etiologies of hemolytic anemia as a possible complication in cases such as concurrent G6PD deficiency, severe parasitemia, or use of parenteral antimalarials. Although artemisinin-based antimalarial therapies are generally well-tolerated, several cases of severe post-artemisinin delayed hemolysis (PADH) have been recently reported, which present a diagnostic challenge, and affect morbidity and mortality in patients with malarial infection. We highlight the case of a young lady with Plasmodium falciparum severe parasitemia who developed hemolytic anemia after parenteral artesunate therapy.

HELLP develops in approximately 0.1–0.8% of pregnancies overall and as many as 15–20% of patients with HELLP syndrome do not have antecedent hypertension or proteinuria. The risk factor for development of ascites is extensive structural damage of the microvasculature in patients complicated by HELLP. The aim of this study is to report a case with HELLP syndrome complicated with massive ascites after vaginal delivery that eventually resolved spontaneously.

Introduction Increasing pressure and limitations on the NHS necessitate simple and effective ways for maintaining standards of patient care. This quality improvement project aims to design and implement user-friendly and clear ward round stickers as an adjunct to surgical ward rounds to evidence standardised care.Project design and strategy Baseline performance was measured against the recommended standards by the Royal College of Physicians, General Medical Council and a study performed at the Imperial College London. A total of 16 items were studied. All members of staff in surgery department were informed that an audit on ward round entries would be implemented but exact dates and times were not revealed. In the first cycle, ward round sticker was implemented and results collected across three random days for use and non-use of sticker. Feedback was collected through the use of questionnaires. In the second cycle, the ward round sticker was redesigned based on feedback and results collected for use and non-use of sticker.Results Baseline performance noted in 109 ward round entries showed that checking of drug chart, intravenous fluid chart, analgesia, antiemetic, enoxaparin, thromboembolic deterrents ranged from 0% to 6%. With the introduction of ward round stickers in both cycles, there was noticeable improvement from baseline in all items; in ward round entries where stickers were not used, performance was similar to baseline.Conclusion This quality improvement project showed that the use of stickers as an adjunct to surgical ward round is a simple and effective way of evidencing good practice against recommended standards. Constant efforts need to be made to promote compliance and sustainability. Commitment from all levels of staff are paramount in ensuring standardised patient care without overlooking basic aspects.