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Background:The scale of the 2022 global mpox (formerly known as monkeypox) outbreak has been unprecedented. In less than 6 months, non-endemic countries have reported more than 67 000 cases of a disease that had previously been rare outside of Africa. Mortality has been reported as rare but hospital admission has been relatively common. We aimed to describe the clinical and laboratory characteristics and outcomes of individuals admitted to hospital with mpox and associated complications, including tecovirimat recipients. Methods:In this cohort study, we undertook retrospective review of electronic clinical records and pathology data for all individuals admitted between May 6, and Aug 3, 2022, to 16 hospitals from the Specialist and High Consequence Infectious Diseases Network for Monkeypox. The hospitals were located in ten cities in England and Northern Ireland. Inclusion criteria were clinical signs consistent with mpox and MPXV DNA detected from at least one clinical sample by PCR testing. Patients admitted solely for isolation purposes were excluded from the study. Key outcomes included admission indication, complications (including pain, secondary infection, and mortality) and use of antibiotic and anti-viral treatments. Routine biochemistry, haematology, microbiology, and virology data were also collected. Outcomes were assessed in all patients with available data. Findings:156 individuals were admitted to hospital with complicated mpox during the study period. 153 (98%) were male and three (2%) were female, with a median age of 35 years (IQR 30–44). Gender data were collected from electronic patient records, which encompassed full formal review of clincian notes. The prespecified options for data collection for gender were male, female, trans, non-binary, or unknown. 105 (71%) of 148 participants with available ethnicity data were of White ethnicity and 47 (30%) of 155 were living with HIV with a median CD4 count of 510 cells per mm3(IQR 349–828). Rectal or perianal pain (including proctitis) was the most common indication for hospital admission (44 [28%] of 156). Severe pain was reported in 89 (57%) of 156, and secondary bacterial infection in 82 (58%) of 142 individuals with available data. Median admission duration was 5 days (IQR 2–9). Ten individuals required surgery and two cases of encephalitis were reported. 38 (24%) of the 156 individuals received tecovirimat with early cessation in four cases (two owing to hepatic transaminitis, one to rapid treatment response, and one to patient choice). No deaths occurred during the study period. Interpretation:Although life-threatening mpox appears rare in hospitalised populations during the current outbreak, severe mpox and associated complications can occur in immunocompetent individuals. Analgesia and management of superimposed bacterial infection are priorities for patients admitted to hospital.

The T-DNA insertional mutant assemblies of genes of Arabidopsis thaliana are making a significant contribution toresearch in plant biology since past two decades. A broad-spectrum of problem in plant biology intended at in-vivo genecharacterization for various functions were being studied by these mutant alleles. The study was undertaken to appraisethe regulatory role of ascorbate oxidase gene in plant development to see its role in reactive oxygen species. To evaluatethe functional role of ascorbate oxidase a mutant lacking AO was compared to the wild-type. For this purpose, a salk-linehomozygous for an insertion in the AO coding sequence was used and verified for the presence of the insertionalmutagenesis. Much effort needs to complete this picture, and ultimately fulfill the present-day gap in our judgement ofsuch potential instigator of plant responses.

The examination was done to decide the all-out phenolics, all-out flavonoids, and in-vitro antioxidants of M. longifolia gathered from various areas (Rawalakot, Khaigala, Akhorban, Alisojal, Phirkot, Bhaikh, and Singola) of Poonch, Azad Jammu, and Kashmir. The watery concentrates of M. longifolia were surveyed for absolute phenolics, all-out flavonoids, restraint against thiobarbituric acid reactive species (TBARS) prompt by various star oxidants (10µM FeSo4 and 5µM sodium nitroprusside) in mice liver and brain homogenates, DPPH radical searching limit, iron-chelating power. The outcomes demonstrated that M. longifolia contained a generous level of phenolic (192.10±2.10 mg/g) and flavonoid compounds (4.23±0.03 mg/g) separately. Among various areas, the Alisojal indicated the most elevated antioxidant movement against lipid peroxidation prompted by iron in mice liver (IC50, 23.67±2.67 µg/ml) and brain (IC50, 13.85±0.85 µg/ml) and showed the most noteworthy cell reinforcement action against sodium nitroprusside in mice liver (IC50, 14.76±1.76 µg/ml) and brain (IC50, 14.05±1.05 µg/ml). The concentrates of various areas likewise demonstrated promising DPPH radical searching (IC50, 30.47±1.47 - 71.77±2.77 µg/ml) and metal-chelating activities (IC50, 40.67±0.89 - 90.92±3.92 µg/ml). In general, it was presumed that M. longifolia may be an expected wellspring of phenolic and flavonoid mixes bearing a considerate of the antioxidant character towards animal tissues.

One sixth of the world’s population is suffering from hidden hunger that indicates a gross malnutrition particularly among children and women of third world countries. The deficiency of micro nutri...

A ruptured sinus of Valsalva aneurysm rarely accompanies the aortic valve endocarditis. A 40-year old female presented with low threshold exertional dyspnea and fever. Transthoracic and transesophageal echocardiography showed ruptured sinus of Valsalva aneurysm in right ventricle with multiple vegetation at the aortic root. Initial blood cultures were negative and an empirical antibiotic therapy was started. Patient was operated for surgical repair of sinus of Valsalva aneurysm. An aortic root abscess with rupture of sinus of Valsalva was found at operation. However, postoperatively she developed sepsis and multiorgan failure leading to her death. J Microbiol Infect Dis 2018; 8(2):69-72

Background. Infective endocarditis (IE) is an uncommon but life-threatening infection. It is commonly associated with diseased or damaged valves. Patients with congenital heart disease are more prone to getting IE than the general population. The typical organisms that cause IE include Staphylococcus , Coagulase-negative Staphylococcus, Streptococcus viridians and Enterococci. However, the importance of rare micro-organisms like Kocuria kristinae should not be underestimated especially when isolated from multiple blood cultures in patients suspected of IE. Case presentation. We report a rare case of right-sided infective endocarditis due to K. kristinae in a young non-diabetic, non-addict female of low socioeconomic class who presented with undiagnosed fever for 1 year. She was investigated and treated for fever by several general practitioners without relief. Later on, she was diagnosed by a local cardiologist to have perimembranous ventricular septal defect with a small pulmonary valve vegetation. She was referred to a tertiary care cardiac hospital in Rawalpindi, Pakistan for further management. Transthoracic and transesophageal echocardiography confirmed IE secondary to preexisting congenital heart disease complicated with a small pulmonary vegetation. Her blood cultures yielded growth of K. kristanae, a rare micro-organism to cause IE. The patient responded to the antibiotic therapy. Conclusion. Clinicians should have a high index of suspicion for K. kristanae IE as a possible cause of a prolonged fever especially in the presence of congenital heart disease. Antibiotic susceptibility is required for adequate therapy.

Background. Francisella tularensis is a rare zoonotic bacterium that spreads sporadically by various routes, including infected arthropod bites, ingestion of contaminated water and inhalation of contaminated dust. However, its occurrence in postoperative chest infection has never been reported. Pathogen isolation, serology and molecular detection methods are commonly used for the diagnosis of tularaemia. Case presentation. We present the first case report of the isolation of F. tularensis from a patient with a chest infection (a boy in his teens) following cardiac surgery for closure of a ventral septal defect. It was isolated on blood and chocolate agar on the third day after the subculture of drain fluid collected in a blood culture bottle incubated in Bact T/Alert 3-D (bioMerieux, France). The organism was identified as F. tularensis by Vitek GN ID Cards (Vitek 2 Compact, bioMerieux, France). The patient made a smooth recovery with antibiotic therapy. Conclusion. F. tularensis can cause post-operative infection, especially in patients with a rural background.

Seabuckthorn (Hippophae rhamnoides L.) is a hardy fruit-producing plant. With medicinal and nutraceutical properties, its fruits, seeds and leaves are enriched with astonishing array of nutrients. Especially, its bark contains vitamins, essential oils and minerals, for which most of the staple crops are deficient. This study was envisaged to isolate the folate pathway HPPKDHPS ortholog from seabuckthorn. The target gene Hydroxymethyldihydropterin pyrophosphokinase–dihydropteroate synthase linked in the pathway of folate biosynthesis was successfully isolated and cloned. The sequences analysis revealed that this novel genomic locus is 2354 bp in size. The coding region is interrupted by a single large intron. The coding sequence is 1539 bp long which is similar to its ortholog in tomato. The newly isolated gene has prominent nucleotide mutations randomly distributed over the entire length of the sequence. Mutations are only of substitution type, and no deletions or insertions are detectable. All the mutations were of non-synonymous type. Expression profile of HrHPPK-DHPS with semiquantitative RT-PCR revealed the higher accumulation of transcripts in leaf and fruits tissues. Phylogenetic reconstruction revealed gene duplication in soybean and Arabidopsis orthologs. A considerable conservation in 3-dimensional structure of folate protein HPPK-DHPS was observed; however, notable differences in substrate binding pockets were also visible. Hence, HrHPPK-DHPS is a novel ortholog isolated from medicinal plant seabuckthorn. © 2016 Friends Science Publishers

Endocarditis is associated with significant morbidity and mortality world over especially in the developing countries. The disease has varied presentations. Common etiological agents include Streptococcus viridians, Coagulase negative Staphylococcus, Staphylococcus aureus and Enterococus in the culture positive endocarditis. Rarely fungi may also lead to vegetations which are often large in size and require surgery beside medical treatment. We present a case case report of endocarditis due to Aspergillus species with Brucellosis presented is in a lady treated with valvular replacement and antifungal therapy with voriconazole.

Introduction: King Faisal Specialist Hospital and Research Center (KFSHRC) workforce is composed of close to 67 different nationalities. Diversity in the nursing workforce is unique in the hospital reason being the expatriates outnumber the Saudi nationals. Staff from different backgrounds provides a different perspective to the clinical care ensuring the hospital standards and policies are adhered to. In the Intensive Care Unit (ICU), when these new nurses arrive, their grasp of Arabic is limited. It is essential that nurses understand the language of their patients. In intensive care setting, patient’s condition is critical and highly specialized nursing care is paramount to the safety of the patient. It poses a challenge for non-Arabic speaking nurses to overcome the language barriers, to ensure high quality care is provided to the patient, maintain patient satisfaction and confidentiality. Therefore, communication tool kit is developed to overcome the language barrier. The tool kit is an educational instrument for non-Arabic speakers by expediting learning most frequent terms and words in Arabic. Aim: The purpose of this study is to focus on the importance of implementing a communication toolkit to enhance the communication between the nurse and the patient. Moreover, this study attempted to evaluate the efficacy of this communication tool prepared for non-Arabic health care providers. Method: Descriptive Quantitative pre and post-test study design was used. This study included all adult intensive care units and non-Arabic speaking nurses from KFSHRC in Riyadh. The pre and post questionnaire was developed by a panel of experts working in the ICU. The communication toolkit was created by direct care staff nurses working alongside the multidisciplinary team to address communication barriers. Baseline assessment was conducted which highlighted the common words and culturally appropriate images used by the Arabic patients. After the approval of the ethics and research board the study was conducted. Recruitment of the participants was performed on a voluntarily basis. On the basis of the sample size, 95 percent level of confidence, 73 participants were recruited. The communication toolkit was distributed for the duration of three months. Follow up was performed by the investigators after three a months’ time frame. Results: The results of the study showed that 90 percent of the nurses did not study Arabic prior to their arrival in the hospital. 72 nurses completed the pre and post questionnaires. Majority of the nurses were from Asian countries and few were from Western countries. Most of the nurses were using interpreters to overcome the language barrier. With regards to the questionnaire 94 percent of the nurses viewed that this toolkit will overcome their language difficulties. 19 percent used the toolkit daily, 55 percent used it twice per week and 16 percent used once per month. In regards to the efficacy 83 percent stated that this toolkit is a good mode of communication with the patients. 50 percent of the nurse highlighted the need for Arabic classes. Conclusion: This study highlights the need for the toolkit to improve the language barriers. Most of the nurses have suggested Arabic classes, access to electronic devices and need for interpreters to overcome the language barrier. The toolkit is important and is to be made available in all areas of the organization.

Shewanella is Gram-negative motile bacillus, non fermentative and facultative anaerobe. Its natural habitat is all forms of water and soil, but has also been isolated from fish, dairy products, oils, and carcasses. Often found with microflora of the marine environment. Bacterial infections with Shewanella spp. are rare. The exposure to the marine environment, sea and diary food are considered as a risk factor for Shewanella spp. infection. Clinical infections seen are otitis, soft tissue infection, bacteremia, ear infection, eye infection, infective arthritis, osteomyelitis, infective endocarditis and peritonitis.

Parasitic infestation is very common in developing countries. Major factors of worm infestation are poor socio-economic status, large family size, low educational level, and poor hygiene and sanitation. These parasites lead to nutritional deficiencies and various diseases. A few studies have been carried out in Pakistan and this study tries to find out the frequency of parasitic infestation in our setup.A cross sectional study was carried out from December 2011 to February 2012 in Pakistan Aeronautical Complex (PAC) Hospital Kamra. Patients were asked to pass stool specimen in a universal container provided to them from the laboratory. Stool specimens were examined within half an hour by direct light microscopy of faecal smears in normal saline. The laboratory diagnosis was based on the demonstration of ova/cysts or trophozoites. Data were analysed by SPSS-10 and frequency of various parameters was determined.A total of 543 faecal specimens were tested. Specimens found positive for ova/cysts were 295 (54%). Ascaris lumbricoides was the most frequent parasitic infestation in all faecal specimens followed by Taenia saginata. Thirty percent of food handlers were harbouring different parasitic infections. Diarrhoea/dysentery, medical examination of food handlers and for secondment abroad was the most frequent indication for faecal examination.High frequency of parasitic infestation in our set up especially of Taenia species requires measures to improve hygiene, water and sanitation. Meat and its products should be obtained from medically fit animals and meat cooked thoroughly before being consumed.