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Clostridium haemolyticum is the causal agent of bacillary hemoglobinuria in cattle, goat, sheep, and ruminants. In this study, we report the first recorded human-infecting C. haemolyticum strain collected from an 18-year-old woman diagnosed with acute lymphoblastic leukemia. After failure of traditional techniques, only next-generation sequencing (NGS) technology in combination with bioinformatics, phylogenetic, and pathogenomics analyses revealed that our King Faisal Specialist Hospital and Research Center (KFSHRC) bacterial isolate belongs to C. haemolyticum species. KFSHRC isolate is composed of 1 chromosome and 4 plasmids. The total genome size is estimated to be 2.7 Mbp with a low GC content of 28.02%. Comparative pathogenomics analysis showed that C. haemolyticum KFSHRC isolate is a potential virulent pathogenic bacterium as it possesses the virulence factors necessary to establish an infection, acquire essential nutrients, resist antimicrobial agents, and tolerate hostile conditions both in the human host and in its surrounding environment. These factors are included in the main chromosome in addition to novel recombination of the plasmids, and they could be the reason for the incidence of that human infection. This work demonstrated the importance of using NGS in medical microbiology for pathogen identification. It also demonstrates the importance of sequencing more microbial samples and sharing this information in public databases to facilitate the identification of pathogenic microbes with better accuracy.

To overcome the limitations of current diagnostic methods for brucellosis, accurate and simple methods must be sought. In this study, sera of patients diagnosed with brucellosis were examined by polymerase chain reaction (PCR) for the detection of Brucella DNA. Results showed that an amplicon of 223 bp was obtained in 96% (24/25) of tested sera using primers derived from the nucleotide sequence of a gene encoding the 31-kDa Brucella abortus antigen. However, when serum DNA templates were examined by another PCR, an amplicon of 731 bp was obtained in 60% (15/25) of the tested samples using Brucella melitensis-specific primers derived from a polymorphic locus adjacent to the 3' end of IS711. The specificity of each PCR was demonstrated by inclusion of reference Brucella DNA strains and by DNA sequence analysis of PCR products. These results suggest that serum analysis by PCR is a convenient and safe method for rapid and accurate diagnosis of brucellosis and that B. melitensis is the leading cause of brucellosis in Saudi Arabia.

Brucellosis is a zoonotic and contagious infectious disease caused by infection with Brucella species. The infecting brucellae are capable of causing a devastating multi-organ disease in humans with serious health complications. The pathogenesis of Brucella infection is influenced largely by host factors, Brucella species/strain, and the ability of invading brucellae to survive and replicate within mononuclear phagocytic cells, preferentially macrophages (Mf). Consequently, the course of human infection may appear as an acute fatal or progress into chronic debilitating infection with periodical episodes that leads to bacteremia and death. The existence of brucellae inside Mf represents one of the strategies used by Brucella to evade the host immune response and is responsible for treatment failure in certain human populations treated with anti-Brucella drugs. Moreover, the persistence of brucellae inside Mf complicates the diagnosis and may affect the host cell signaling pathways with consequent alterations in both innate and adaptive immune responses. Therefore, there is an urgent need to pursue the development of novel drugs and/or vaccine targets against human brucellosis using high throughput technologies in genomics, proteomics, and immunology.

The effects of grading on the performance of heterojunction bipolar transistors (HBTs) are studied by numerically solving the basic semiconductor equations. The numerical modelling is based on the extended drift–diffusion formulation with inclusion of thermionic emission current at the heterointerface of abrupt emitter HBTs. The results of the simulation show that the graded layer improves significantly the current driving capability of the HBT and lowers its offset voltage. However, owing to the increase in the recombination in the graded layer, the current gain of the graded HBT is lower and depends strongly on the bias at low and medium bias range. The simulation also reveals the presence of a potential minimum in the conduction band of the graded emitter HBT, which results in an electron accumulation in the region. This accumulation increases the emitter-base capacitance and its charging time, leading to a smaller unity-gain frequency f T.

Corticosteroids are beneficial as treatment of certain tuberculosis syndromes. We reviewed all cases of peritoneal tuberculosis diagnosed at our institution over 10 years to evaluate the role of corticosteroid administration combined with antituberculous therapy. Nine patients were treated with steroids plus antituberculosis agents (cases), and 26 received antituberculosis treatment only (controls). The two groups were not significantly different in terms of their basic demographics or disease. Nineteen controls compared with one case had recurrent abdominal pain. Seven controls had 17 emergency department visits because of abdominal pain. Intestinal obstruction was diagnosed for five of these patients, four of whom underwent laparotomy revealing extensive adhesions. Three controls died, and no case died. No case required laparotomy, had a diagnosis of intestinal obstruction, or visited the emergency department because of abdominal pain. These findings suggest that corticosteroid administration combined with antituberculosis treatment reduces the frequency of morbidity and complications in patients with peritoneal tuberculosis.

The aim of this study was to determine the relationship between bone levels observed on dental panoramic tomographs (DPT) and the WHO/FDI recommended periodontal screening technique: the community periodontal index of treatment needs (CPITN). Computer enhancement and digital analysis were used to improve accuracy and reliability. A total of 199 posterior sextants on DPT radiographs from 50 patients (29 female and 21 male) with a mean age of 42 were examined. A statistically significant relationship was found between CPITN and radiographic measurement from the cemento-enamel junction to the alveolar crestal bone margin (A). The relationship between A and CPITN was found to fit the following equation: square root of A = beta 1 + F, where, F is constant and beta 1 is the coefficient corresponding to the i the codes of CPITN. It was concluded that there was a close correlation between the CPITN screening codes and bone loss as measured on the DPT radiograph.

Chronic hepatitis C is common in Saudi Arabia and most often presents in an advanced stage. To assess the response of patients to interferon, a randomized placebo-controlled double-blind study was undertaken. All but 1 patient had cirrhosis or fibrosis before interferon. After a 24-week observation period patients received alpha 2a interferon, 3 mega units sc tiw or placebo for 24 weeks, then the opposite treatment for another 24 weeks followed by 24 weeks of observation. Liver biopsies were performed before and after each of the treatment phases. Twenty-two out of 24 patients completed the study. The mean alanine aminotransferase (ALT) levels fell from 150.7 +/- 118.7 units/l to 91.0 +/- 42.6 units/l after 6 months interferon treatment (P = 0.03) but only 3 patients (14%) had complete normalization of mean ALT levels and 4 (18%) had50% reduction. The mean hepatitis activity index fell from 12.2 +/- 2.6 immediately before to 11.6 +/- 2.5 just after interferon (P = 0.4). After interferon there was an insignificant raise in 6-month mean ALT. Hepatitis C virus-RNA was positive in all 17 patients tested and remained so after treatment. Side-effects were mild and well tolerated. Alpha interferon 3 mega units tiw for 24 weeks is not an effective treatment of histologically advanced chronic hepatitis C.

This paper presents a new algorithm for Braille cells recognition using image processing technique. Scanned Braille document is composed from three classes of gray-level: (i) background, (ii) recto dots, and (iii) verso dots. We segment the Braille image using a stability thresholding method with a mixture of Beta distributions. To ensure correct detection and extraction of dots composing Braille cells, a grid is formed to contain the Braille dots. We identified a recto dot by a light region that exists above a dark region using the segmented image. In the same way, we identify a verso dot in double sided document by a light region that exists below a dark region. After having recto and verso dots, Braille cells are then recognized based on the standard regrouping of dots. Experimentation showed that Braille cells composing are automatically identified from those grids with excellent accuracy.

The proposed methodology addresses the issue of call quality from the end users and operators perspective. The purpose here is to present the emerging result of the research work, which is more on the development of the software for the speech quality analysis. The idea is aimed at developing an algorithm that will be driven by the operating system to measure certain call parameter during calls and provide average scores at the end of the call. Such call parameters includes, the successful call rate, drop call rate, handover success rate, handover failure rate and Location Area Code (LAC).

In chronic brucellosis due to Brucella melitensis, cell-mediated responses were transiently depressed in comparison to antibody responses. To elucidate the mechanism of immunosuppression, we examined the role of transforming growth factor beta (TGF-beta) in cellular immune responses of 20 patients with chronic brucellosis. Circulating TGF-beta1 level was markedly elevated is sera of patients with confirmed brucellosis as compared with those from Brucella-negative healthy control subjects. In contrast, a 2-fold increase of TGF-beta1 production was demonstrated in patients peripheral blood mononuclear cells (PBMC)-stimulated with Brucella cell extract (BCE) antigen. The increased production of TGF-beta1 protein was dually associated with enhanced expression of TGF-beta mRNA in patients PBMC and diminished lymphoproliferative responses to BCE. A causal relationship between increased TGF-beta1 production and depressed lymphoproliferative responses was demonstrated by treatment of proliferating PBMC with a neutralizing antibody to TGF-beta1 where the lymphocytes function has been restored. These results suggest that the increased activity of TGF-beta1 may underlie the depressed function of T cell responses with consequent prolongation of disease course in patients with chronic brucellosis.

The ever increasing challenges to provide high quality, reliable and low cost mobile voice services have made speech quality a major area of research. Due to evolving and liberalized market, the quality of telecommunication voice services has become an important issue. With the advent of new technologies, however, a diversification takes place which makes it necessary to carefully plan and observe network quality. A characteristic of the competitive telecommunications market is the convergence in many aspects of service, such as price between different operators. In this environment, speech quality is becoming a key factor distinguishing one operator from another — a strong indicator for customer satisfaction. Therefore, it is imperative that a service provider is capable of predicting customers' perceptions of quality so that networks can be optimized and maintained.

Human brucellosis is a zoonotic disease which is endemic in Saudi Arabia. The aim of this study was to investigate the humoral immune responses and identify the target antigens that persist at different stages in human brucellosis during antibiotic therapy. To do this, an acute case of accidental nosocomial infection was studied experimentally. Blood was collected from the patient at the time of diagnosis, and at weekly intervals during therapy until remission. IgG and IgM immunoblotting was used to characterize specific antigenic determinants, and ELISA antibody titration was performed to quantify the circulating antibodies. Results indicated that protein bands of 12–13.5 kDa bound IgG in the patient's sera but did not bind IgM on immunoblots and are probably not specific for, or important in, early stage infections. However, an 18 kDa band persisted during infection through remission. The pivotal and most important findings were that the number of protein bands seen on immunoblots, the magnitude of ELISA antibody titres and the concomitant changes in the intensity of the polypeptide bands of 42–43 kDa were positively correlated with the stage of infection. High numbers of anti-IgG and -IgM immunoblot bands coupled with high ELISA antibody titres and a concomitant increase in intensity of the 42–43 kDa bands were positively correlated with acute and severe infection. Conversely, a reduction in the number of polypeptide bands as well as a decrease in the intensity, until the complete disappearance of the 42–43 kDa bands, coupled with low (baseline) ELISA antibody titration values indicated successful treatment and remission. The routine use of the methods described here to ascertain the stage of the disease, assess the progress of antimicrobial therapy and monitor cases of relapse in human brucellosis is suggested.

Brucellosis is prevalent in Saudi Arabia and Brucela melitensis is a leading cause of zoonosis worldwide. Therefore, accurate diagnosis of brucellosis is a key to its treatment and control.Twenty patients presented with symptoms of brucellosis were examined before and after antibiotic treatment for the diagnosis of brucellosis. Sequential blood samples collected monthly from each patient were tested for the diagnosis of brucellosis by serum plate agglutination test (SPA), standard tube agglutination test (STA), culture, and polymerase chain reaction (PCR).While most of the samples were positive by the agglutination tests, only 40% and 70% were positive by culture and PCR, respectively. After the course of antibiotic treatment, the culture rate and PCR results were positive in 10% of the samples. In contrast, anti-brucella antibodies of the treated patients were positive in 20% and 45% by STA and SPA tests, respectively. Furthermore, agglutinating antibodies in the presence of 2-mercaptoethanol were positive in 60% of the enrolled patients and negative in all patients after the antibiotic treatment.The present study revealed that the expression of anti-brucella antibodies does not correlate with the status of the disease condition. Further, completion of antibiotic therapy hampered the appearance of brucella-specific IgM antibodies, but did not eliminate the appearance of residual IgG antibodies in the treated patients. Therefore, for effective therapy, detection of the Brucella organisms by PCR or culture is an important attribute in the evaluation of the treatment regimen against brucellosis.

Results of a double-blind randomized non-crossover study of rapid (45 min) versus slow (4 h) infusion of amphotericin B administered to 20 patients with proven or suspected fungal infection are reported. Toxicity was higher in the rapid infusion group than it was in the slow infusion group (mean total 7-day chill score, 173 +/- 276 versus 20 +/- 30 [P less than 0.01]; mean total 7-day dosage of meperidine required to abate rigors, 180 +/- 133 versus 58 +/- 78 mg [P less than 0.05]; and mean maximum total 7-day pulse rise, 225 +/- 64 versus 135 +/- 56 beats per min [P less than 0.02], respectively). When analyzed on a daily basis, the mean chill score, meperidine dosage, and pulse rise were also higher; and in addition, nausea and vomiting (5 of 11 patients who received a rapid infusion versus 0 of 9 patients who received a slow infusion [P less than 0.01]) appeared to be more common in those who received amphotericin B rapidly. The daily analysis approach proved that tolerance to these side effects developed with each subsequent infusion day, and by day 7 the incidence and severity were the same. This development of tolerance was significant for the mean chill score in the rapid infusion group (P less than 0.05) and for the proportion of patients with chills (P less than 0.005 for the slow infusion group; P less than 0.05 for the rapid infusion group). A decrease in creatinine clearance to greater than 51% of the baseline value was seen in two patients in each group. There were five deaths (four in the rapid infusion group, 1 in the slow infusion group) within 1 month, but none was clearly related to the amphotericin B infusion. The mean time to defervescence was similar for each group (10.8 +/- 4.1 days in the slow infusion group versus 9.9 +/- 5 days in the rapid infusion group). A rapid infusion regimen for amphotericin B cannot be recommended, at least during the first 5 to 7 days of treatment.

Nine patients with complicated hydatid disease managed with surgery and mebendazole/albendazole are presented. Five patients received albendazole (1 treatment course) and 5 patients received mebendazole (3 had 2 treatment courses, 1 had a switch-over from mebendazole to albendazole). The mean durations of treatment and follow-up were respectively 7 +/- 2.5 months and 7 +/- 2.5 months (albendazole); 13 +/- 10 months and 29 +/- 31 months (mebendazole). A superior clinical and radiological response was seen in 1 patient with disseminated intra-abdominal disease on switching therapy from mebendazole to albendazole. Radiological improvement occurred in 3/5 courses of albendazole and in 2/8 courses of mebendazole. Clinical improvement occurred in 3/5 courses of albendazole and 0/8 courses of mebendazole. Radiological deterioration was demonstrated in 0/5 courses of albendazole and 2/8 courses of mebendazole. Although the impression was that albendazole was superior, good responses were also seen with mebendazole. The heterogeneity of the patients, their disease, short follow-up time, lack of more sensitive noninvasive assay techniques urges caution before firm conclusions can be drawn.