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Marian A Gerges,1 Yasmin Ahmed Fahmy,1 Thoraya Hosny,2 Nessma H Gandor,2 Sherif Y Mohammed,2 Tahia Mohamed Ahmed Mohamed,2 Nabila Elsayed Mousa Abdelmoteleb,3 Noura E Esmaeel1 1Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt; 2Clinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt; 3Gynecology and Obstetrics Department, Faculty of Medicine, Zagazig University, Zagazig, EgyptCorrespondence: Marian A Gerges, Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, 44519, Egypt, Tel +2 01003819530, Email MAGerges@zu.edu.egBackground: Candida albicans (C. albicans) is a major cause of vulvovaginal candidiasis (VVC), a condition that is commonly treated with azole agents. Biofilm formation and aspartyl proteinase production are important virulence factors that could be linked to azole resistance in C. albicans impeding therapy.Aim: To find out the association of both factors with azole resistance among C. albicans isolated from VVC cases in Egyptian nonpregnant women of childbearing age.Patients and Methods: In a cross-sectional study, C. albicans was isolated from nonpregnant females diagnosed clinically as having VVC during a 1-year study period. Susceptibility to azole agents was tested using the disc diffusion method. Biofilm formation and aspartyl proteinase production were assessed phenotypically. Additionally, two biofilm-related genes (ALS1 and HWP1) and three proteinase genes (SAP2, SAP4, and SAP6) were screened for using polymerase chain reaction (PCR).Results: Among 204 C. albicans isolates, azole resistance ratios were as follows: voriconazole (30.4%), itraconazole (17.6%), fluconazole (11.3%) and econazole (6.4%). Biofilm-producing capacity was detected in 63.2% of isolates, and 63.2% were proteinase producers. The frequencies of ALS1 and HWP1 were 69.6% and 74.5%, respectively, while SAP2, SAP4, and SAP6 were 69.2%, 88.7%, and 64.7%, respectively. Biofilm formation was significantly associated with azole resistance (P < 0.001 for each tested azole agent) as was proteinase production (P < 0.001 for fluconazole, voriconazole, and econazole resistance and P = 0.047 for itraconazole).Conclusion: Among nonpregnant Egyptian women of childbearing age, azole resistance in C. albicans causing VVC is significantly associated with biofilm formation and proteinase production. The development of new therapeutic agents that can target these factors is warranted.Keywords: Candida albicans, vulvovaginal candidiasis, biofilm formation, aspartyl proteinase, azole resistance

Hyperthyroidism complicates few pregnancies, in many cases due to Graves' disease. Gestational trophoblastic disease is a rare cause of hyperthyroidism in which high levels of hCG causes activation of the thyrotrophin receptor to stimulate supraphysiological secretion of thyroid hormone with or without thyroid gland enlargement. Molar pregnancies are usually not recurrent, however, women with a previous hydatidiform mole (HM) are at higher risk of having a second mole than women from the general population. After a prior molar pregnancy, the risk of having a second one is 540 times that of the general population, however, familial molar pregnancies are exceedingly rare. Here we present a case of recurrent HM complicated by a toxic goiter in a patient with family history of molar pregnancy

Background: Cleft lip and/or cleft palate are the most prevalent craniofacial anomalies visible to the naked eye. Variations in haematological parameters can be used to determine if the immune system of these patients has been altered as a result of nutrition difficulties and recurrent infections. This study sought to determine the prevalence of malnutrition, including deficiencies in major micronutrients such as iron, folate, and vitamin B12, among children with cleft lip and/or palate, and to determine which nutritional interventions can improve the situation for these children. Methods: All infants with cleft lip and/or cleft palate younger than 5 years who attended our institute were included. On their initial visit, the following were documented: demographic information, an assessment of malnutrition, and investigations including a complete blood count and peripheral blood film examination, as well as serum levels of albumin, ferritin, iron, folate, and vitamin B12. Results: The study included 115 patients, 26 (52%) of whom were male and 24 (48%) of whom were female. 19 (38%) had a cleft lip, 10 (20%) had only a cleft palate, and 21 (42%) had both clefts. Conclusion: Iron deficiency is almost universally present in children with cleft lip and palate, according to a study. Therefore, iron and folic acid supplements should be administered upon initial contact to enhance iron reserve and haematological parameters for optimal and safe surgical outcomes.

Objective: To identify risk factors that may contribute to recurrent wheezing in infants under the age of five. Material and Method: In the Outpatient Department of Saveetha Medical College and Hospital, Chennai, a cross-sectional investigation was conducted on children younger than 5 years old. The study group consisted of fifty infants with symptoms and signs of recurrent wheezing. All of the parents filled out the questionnaires provided. To comprehend the characteristics of the study groups, a statistical analysis of descriptive data was conducted. The risk factors were analyzed using bivariate and multivariate statistical analyses that included all significant predictors with a p

Cell line authentication using Short Tandem Repeats (STRs) is necessary to ensure the integrity of the cell for its continuous culture and to identify misidentification and cross-contamination issues. This study investigates the changes in the genetic profile of MCF-7 and HepG2 cell lines caused by the methanolic leaf extract of Anastatica hierochuntica (AH) using human identification based STR markers. MCF-7 and HepG2 cell lines were treated with various concentrations of AH extracts for three different periods. The treated and control cells' DNA was extracted using a QIAamp® DNA Micro Kit, quantified using a Quantifiler Duo DNA Quantification Kit, and amplified using an AmpFlSTR Identifiler plus PCR Amplification Kit. The concentrations of the DNA extracted from control and MCF-7 and HepG2 cell lines treated with AH extract at 300 to 2400 µg/ml for 24hr and 150 to 2400 µg/ml for 48 and 72hrs were statistically significant (p

Breast cancer therapy using anticancer bioactive compounds derived from natural products as adjuvant treatment has gained recognition due to expensive and toxic conventional chemotherapeutic drugs. The whole plant of Anastatica hierochuntica (L.) (A. hierochuntica) has been investigated for its pharmacologically important anticancer properties but without categorizing the biological activities of the plant parts. We assessed the anticancer potential of different parts of A. hierochuntica (seeds, stems and leaves) and explored their mechanisms of action using the human breast cancer cell line, MCF-7. Currently, we investigated the antiproliferative effects of methanolic (MSD, MST, ML) and aqueous (ASD, AST, AL) extracts of A. hierochuntica plant parts on the MCF-7 cells using cell viability assays. Flow cytometry, Western Blot, DNA fragmentation, and gene expression assays were performed to evaluate apoptosis and cell cycle regulatory proteins. The results indicate that the methanolic and aqueous extracts decreased MCF-7 cell viability in a dose-dependent manner. The induction of apoptosis was observed in all the methanolic and aqueous-treated MCF-7 cells. The cell death process was confirmed by the visualization of DNA fragmentation and cleavage of the intrinsic apoptotic pathways, caspase-9 and caspase-3, the key enzyme causing apoptosis hallmarks. In addition, the most pro-apoptotic extracts, ASD and ML, up-regulated the expression of pro-apoptotic Bax, tumor suppressor TP53 genes and the cyclin inhibitor CDKN1A gene. In conclusion, of the aqueous and methanolic extracts of A. hierochuntica plant parts exerting antiproliferative effects through the induction of apoptosis in breast cancer MCF-7 cells, ASD and ML extracts were the most promising natural-based drugs for the treatment of breast cancer.

Compatibilizers effect on recycled acrylonitrile butadiene rubber (NBRr) with polypropylene (PP) and sugarcane bagasse (SCB) composite for mechanical properties is evaluated. Trans-Polyoctylene Rubber (TOR) and Bisphenol a Diglycidyl Ether (DGEBA) are used as compatibilizers in this study. Three (3) different composites (80/20/15, 60/40/15, and 40/60/15), with fixed filler (15 phr) and compatibilizers (10 phr) content, were carried out. These composites were arranged via melt mixing technique utilizing a heated two-roll mill at a temperature of 180°C for 9 minutes employing a 15-rpm rotor speed. Tensile and morphological properties were evaluated. The result shown average tensile strength dropped by 48.50% as the recycle NBR content rises 20 phr. Nevertheless, subsequent compatibilization reveals that the composites’ tensile properties were all greater than control composites. The morphology discovered validates the tensile properties, indicating a stronger interaction between the PP/SCB and recycle NBR composites with the addition of compatibilizer DGEBA.

Two Dhaka, Bangladesh, landfills are explored to understand how management practices impact environmental quality and public health in the surrounding areas. A combination of research methods is used, such as geospatial buffer zone analysis, semi-structured observation checklist and qualitative interviews, to gain an understanding of the waste transportation, leachate percolation, and adverse health and environmental effects. A multi-ring buffer zone and ground truth method were applied through ArcMap for the spatial distribution of landfill-adjacent environmental features. Qualitative interviews were conducted with landfill officials and nearby residents. Findings reveal that landfills are situated very close to residential areas, water bodies and agricultural lands, exposing them to various health and environmental hazards. Improper solid waste management practices of the landfills cause adverse environmental effects by leachate percolation, waste incineration and vector breeding. Adjacent dwellers suffer from bronchial diseases, pneumonia, diarrhoea, itching problems, headache and appetite loss. The existing solid waste management system requires managerial and technical modifications to reduce the associated environmental pollution and health hazards. 'Practice relevance' Waste management practices impact directly on environmental and public health. Dhaka’s existing waste management practices can become better organised to address these concerns. Source waste reduction must be implemented to ensure the reduction of disposed waste at landfills. Administrative capacity of landfills requires improvement to ensure proper waste management procedures. Increased awareness is also needed among the general population and waste handlers about the adverse effects of uncontrolled waste dumping, along with enforcement measures for improper waste practices. Application of a low-tech, simple and innovative method to improve the leachate treatment process is also needed. Environmentally friendly treatments should be considered in order to minimise landfill odour. Regular training programmes and monitoring activities are needed to ensure the proper utilisation of comfortable and convenient safety gear and reduce vector breeding.

An Ethernet passive optical network (EPON) is an optical access network that allows a higher data rate with low power consumption. To improve energy savings for an EPON, the sleep and doze modes for the optical network units (ONUs) play a pivotal role. Many prediction schemes have been proposed to control these modes. To increase the prediction accuracy, this study proposes an energy-efficient approach that uses a support vector regression (SVR) model. A dynamic bandwidth allocation (DBA) scheme called SVR-DBA is designed to allocate bandwidth to ONUs more efficiently and fairly. To determine the effectiveness of the proposed scheme, simulations are performed. The simulation results show that the proposed scheme decreases energy consumption for ONUs by up to 47% and fulfills the quality-of-service (QoS) requirements in terms of delay, jitter, and packet loss.

The largest recorded Ebola virus disease epidemic began in March 2014; as of July 2015, it continued in 3 principally affected countries: Guinea, Liberia, and Sierra Leone. Control efforts include contact tracing to expedite identification of the virus in suspect case-patients. We examined contact tracing activities during September 20–December 31, 2014, in 2 prefectures of Guinea using national and local data about case-patients and their contacts. Results show less than one third of case-patients (28.3% and 31.1%) were registered as contacts before case identification; approximately two thirds (61.1% and 67.7%) had no registered contacts. Time to isolation of suspected case-patients was not immediate (median 5 and 3 days for Kindia and Faranah, respectively), and secondary attack rates varied by relationships of persons who had contact with the source case-patient and the type of case-patient to which a contact was exposed. More complete contact tracing efforts are needed to augment control of this epidemic.

Background: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are widespread, treatable sexually transmitted infections (STIs) of global significance, affecting millions annually. Left untreated, they pose significant risks, including pelvic inflammatory disease (PID), infertility, and complications during pregnancy. The U.S. Centers for Disease Control recommends annual chlamydial screening for sexually active women to address these risks. Responding to this global challenge, the World Health Organization (WHO) has formulated a global health sector strategy on sexually transmitted infections, outlining priority actions to strengthen STI responses in countries. However, STI epidemiological studies encounter challenges in developing nations like Egypt due to socio-cultural factors, poverty, and limited diagnostic facilities. In Egypt, STI diagnosis primarily relies on clinical presentations, lacking structured screening programs for CT and NG. This study's main objective is to estimate the prevalence of Chlamydial and gonorrheal infections, advocating for supportive STI strategies in Egypt. Additionally, the study aims to provide a foundation for national prevalence estimates of CT and NG infections., Methods: A cross-sectional study encompassed five antenatal clinics in different regions of Egypt. A total of 1040 pregnant women attending these clinics were consecutively sampled. Data collection involved structured questionnaires, and urine samples were subjected to the GeneXpert CT/NG qualitative real-time PCR test., Results: The prevalence of CT infections was 0.29% (95% CI, 0.10-0.86%), with no detected NG infections. The three CT-positive cases were distributed across different recruitment centers, with no statistically significant differences observed between infected and non-infected participants. Notably, 40.3% of recruited women reported gynecological symptoms, primarily discharge. Additionally, 9.6% had undergone previous testing for sexually transmitted infections, with 8.2% receiving positive results., Conclusions: This study provides valuable data on the prevalence of CT and NG infections among pregnant women attending ANC clinics in Egypt. The findings underscore the importance of ongoing surveillance, routine screening, and targeted interventions to ensure the reproductive health and well-being of pregnant women and their infants. Further research is warranted to explore the broader implications of STIs in different populations and to inform evidence-based guidelines for screening and management in diverse settings., Trial Registration: IRB no.: 17,400,017; WHO ERC Protocol Id. A66005., (© 2024. The Author(s).)

Objectives: Social media facilitate the interaction between individuals without regard to the distances between the users. Everybody who has access to internet can suffer from social media addiction. During COVID-19 pandemic there was an increase in social media usage among all population types and especially the university students, which would negatively affect their mental health. Therefore, this study aims at assessing social media addiction and depression among pharmacy students by using questionnaires specifically designed for this purpose., Methods: A cross-sectional study with convenience sampling was conducted from the start of November to the end of December 2021 among undergraduate pharmacy students in Mosul city, Iraq. An online questionnaire was adopted; it consisted of three parts, the first was for collecting socio-demographic and social media usage information, Social Media Addiction Questionnaire (SMAQ) was used in the second part to assess social media addiction of the participants, and the third part was comprised of the Patient Health Questionnaire (PHQ-9) to assess depression among students., Results: Six hundred-three students completed the questionnaire and constituted the final study sample. Instagram was the most used social media program among the students. About 38 % of the students were at risk of becoming addicted on social media, with only 8.4 % of them being minimally or not depressed. Additionally, positive significant correlation was observed between social media addiction and depression. Using social media for more than 4 h and poor academic performance were found to be predictors for social media addiction and depression., Conclusions: Addiction to social media and depression are prevalent among pharmacy students in Iraq and the two are related to each other., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

Introduction: Anticoagulation treatment is routinely underused in patients with atrial fibrillation (AF), particularly in settings with limited resources. The current study is aimed at evaluating the appropriateness of oral anticoagulation treatment among AF patients at the Yekatit 12 Hospital Medical College (Y12HMC), Addis Ababa, Ethiopia., Methods: Institutional-based retrospective cross-sectional study conducted in Y12HMC from November 2019 to March 2020. During the study period, 256 patients' medical records were found; 231 of them met the eligibility criteria and were included in the study. The data were analyzed using SPSS version 25, descriptive statistics were used to summarize the data, and binary logistic regression was performed to identify predictors of inappropriate anticoagulation management., Results: The majority of study participants were males (55.8%), and over half of them (57.6%) had a nonvalvular type of AF. The majority of patients (61.9%) were receiving anticoagulant treatment, and of them, warfarin was prescribed to most of the study subjects (71.3%). Nearly half (47.6%) of the study participants had inappropriate anticoagulation treatment; among these, the majority of them (69.1%) were from a valvular type of AF. Patients with a valvular type of AF and having the diagnosis of congestive heart disease as comorbidity showed a statistically significant association towards inappropriate anticoagulation management., Conclusion: According to the study, a significant portion of AF patients received inappropriate anticoagulant treatment, which may play a significant role for the increased risk of stroke in these groups of patients. All of the inappropriate cases were due to failure to start anticoagulant treatment., Competing Interests: The authors have not declared any conflict of interest., (Copyright © 2023 Abdella Birhan Yabeyu et al.)

BACKGROUND Primary retroperitoneal choriocarcinoma is a rare form of extragonadal germ cell tumor that is highly aggressive and responds poorly to chemoradiation. Extragonadal choriocarcinomas are notoriously challenging to diagnose, and have often progressed to advanced disease by the time of diagnosis. The survival rate for extragonadal choriocarcinoma is approximately 30%, which is much lower than that of extragonadal non-seminomatous germ cell tumors (GCT) in general. CASE REPORT A 24-year-old man with no significant past medical history presented with left-sided, pleuritic chest pain and back pain radiating down his left leg, of 1-year duration. Computed tomography (CT) of the chest revealed multiple bilateral pulmonary nodules and a CT of the abdomen and pelvis showed a large heterogeneous soft tissue mass measuring 9.3×8×10.5 cm. A CT-guided core needle biopsy of a lung nodule was performed and the findings were consistent with the diagnosis of metastatic choriocarcinoma. Magnetic resonance imaging (MRI) of the brain was negative for metastatic disease. Tumor markers were significant for a markedly elevated beta human chorionic gonadotropin (B-hCG) of 104 712 mIU/mL. He was diagnosed with a stage IIIC germ cell tumor, further classified as a primary retroperitoneal choriocarcinoma with lung metastasis, and was started on urgent inpatient chemotherapy. CONCLUSIONS Due to the poor outcomes associated with extragonadal choriocarcinoma, it is important to promptly and correctly identify this malignancy in order to initiate treatment in a timely manner. The following case report explores the histopathologic characterization of this malignancy and describes the clinical course and outcomes from treatment for this patient.

Objective: To study the incidence, causes, and outcome of major ocular complications in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT)., Design: Retrospective, noncomparative, observational clinical study., Participants: The study included a total of 620 patients who underwent allogeneic HSCT in the period from 1997 to 2007 at King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia., Intervention: Allogeneic HSCT., Main Outcome Measures: Patients with ocular complications were referred to the ophthalmology division for complete ophthalmologic examination, including visual acuity, tonometry, Schirmer test, biomicroscopy, and dilated ophthalmoscopy. Laboratory investigations were performed whenever indicated. The incidence and causes of major ocular complications after allogeneic HSCT were determined. Visual acuity at 1 year after allogeneic HSCT was recorded., Results: Major ocular complications occurred in 80 (13%) of 620 patients who underwent allogeneic HSCT. There were 36 male patients (45%) and 44 female patients (55%) with a mean age of 29 years and an age range of 9 to 65 years. Prophylaxis for graft-versus-host disease (GVHD) consisted of cyclosporine and methotrexate in 69 patients, and cyclosporine, methotrexate and corticosteroids, or mycophenolate mofetil in 11 patients. The most frequently encountered ocular complications were chronic GVHD, dry eye syndrome without GVHD, corneal ulcers, cataract, glaucoma, cytomegalovirus retinitis, fungal endophthalmitis, and acquisition of allergic conjunctivitis from atopic donors. There was no correlation between the pattern of ocular complications and the transplanted stem cell source. Best-corrected visual acuity (BCVA) at 1 year after transplantation was less than 20/200 in 13 patients (16%), less than 20/50 in 17 patients (21%), and better than 20/50 in 50 patients (63%)., Conclusions: Ocular complications are common in patients undergoing allogeneic HSCT. Early recognition and prompt treatment are important., Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

It has been suggested that a drug which selectively inhibits platelet thromboxane synthesis, sparing vascular synthesis of prostacyclin, would be more effective as an anti-thrombotic agent. We studied the effect of an aqueous extract of garlic on the production of thromboxane and prostacyclin by rabbit whole blood and aorta in vitro and ex vivo. A dose-dependent inhibition of thromboxane production was observed during blood clotting. Synthesis of prostacyclin was not affected by any concentration of garlic extract used in the experiment. A slight but insignificant reduction in the vascular synthesis of prostacyclin was observed at the highest concentration of garlic used in in vitro experiments. The synthesis of thromboxane by aorta was completely suppressed at all the concentrations of garlic tested. A similar pattern of results was observed after intraperitoneal administration of garlic (1 ml/kg) for one week on the enzymatic synthesis of thromboxane and prostacyclin of these tissues ex-vivo. Aortic synthesis of prostacyclin was significantly increased in the garlic treated rabbits compared to the controls. The data obtained from these rabbit experiments suggested that it may be possible to achieve a selective suppression of thromboxane formation by platelets with sparing of vascular synthesis of prostacyclin by garlic treatment.