Search

The study objectives were to analyze catheter-associated bloodstream infection (CABSI) risk factors in chronic kidney disease on regular hemodialysis and identify the bacterial species responsible for this by molecular analysis. This research was conducted in Erbil Teaching Hospital-Dialysis Unit in Erbil City-Kurdistan Region-Iraq from January to June 2024. It has been performed on 100 hemodialysis samples from both males and females. The investigation showed that the prevalence of CABSI among hemodialysis patients was 44 (44%) out of 100 (100%). The highest percentage of patients were aged between 60-69 years (32%, OR= 0.9, 95%CI [0.1-2.4], P< 0.001) and also male (66%, OR=2.7, 95%CI [0.9-9.4], P< 0.032). Additionally, the patients with Diabetes Mellitus were 70%, (OR= 6.3, 95%CI [0.3-10.4], P< 0.031), and with hypertension was 92%, (OR= 3.1, 95%CI [0.21-5.4], P<0.02.  However, the dialysis duration of most patients was between 1-3 months (60%, OR=0.1, 95%CI [0.1-3.2], P<0.006) and the majority used two catheters (52%, OR= 0.6, 95%CI [0.1-3.2], P<0.012). The most common pathogens identified were Staphylococcus epidermis (44 cases, 100%), Pseudomonas aeruginosa (29 cases, 66%), and, Acinetobacter baumanni (24 cases, 55%). Thirteen bacterial species were recorded in the NCBI GenBank database. The phylogenetic tree demonstrated the distribution and relationship between these bacteria in hemodialysis patients. It showed that the bacterial species were closely related. To lower the risk of catheter-associated bloodstream infection, medical staff should actively develop countermeasures and gain a thorough understanding of the risk factors, which include age, diabetes, length of catheterization, and catheterization site.

Background: Ventilator-associated pneumonia (VAP) is the second most prevalent nosocomial infection in emergency care settings. An emerging strategy to reduce this risk involves coating endotracheal tubes (ETTs) with noble elements, leveraging the antimicrobial properties of elements such as silver, gold, and palladium. This systematic review and meta-analysis aimed to evaluate the effectiveness of noble element coatings on ETTs in reducing VAP incidence rates, mortality, duration of mechanical ventilation, and length of stay in the intensive care unit (ICU)., Methods: Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a comprehensive search was conducted across 5 databases up to 2024. The quality of the randomized controlled trials was assessed using the updated Cochrane Risk of Bias (RoB) 2 tool. A random-effects meta-analysis was performed using RevMan 5.4 Comprehensive Meta-Analysis software. Statistical heterogeneity among the studies was evaluated using the Higgins I2 value, with P < .05 indicating statistical significance., Results: Seven randomized controlled trials from 5 countries were identified. Four studies had some concerns regarding bias, 2 had a high RoB, and 1 had a low RoB. Noble metal-coated ETTs resulted in a lower incidence of VAP compared to noncoated ETTs (relative risk, 0.76 [95% confidence interval [CI], 0.60-0.96]). However, there was no significant difference in mortality rates (relative risk, 1.06 [95% CI, 0.93-1.20]), duration of mechanical ventilation (mean difference, -0.10 [95% CI, -1.62 to 1.41]), and ICU stay (mean difference, 0.07 [95% CI, -1.98 to 2.12])., Conclusion: Noble metal-coated ETTs effectively reduce the incidence of VAP but do not significantly impact mortality rates, the duration of mechanical ventilation, or ICU stay. Therefore, these coated ETTs should be integrated into a holistic care plan addressing all aspects of patient management in emergency care settings., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Thalassemia is one of the most prevalent monogenic disorders in low- and middle-income countries (LMICs). There are an estimated 270 million carriers of hemoglobinopathies (abnormal hemoglobins and/or thalassemia) worldwide, necessitating global methods and solutions for effective and optimal therapy. LMICs are disproportionately impacted by thalassemia, and due to disparities in genomics awareness and diagnostic resources, certain LMICs lag behind high-income countries (HICs). This spurred the establishment of the Global Globin Network (GGN) in 2015 at UNESCO, Paris, as a project-wide endeavor within the Human Variome Project (HVP). Primarily aimed at enhancing thalassemia clinical services, research, and genomic diagnostic capabilities with a focus on LMIC needs, GGN aims to foster data collection in a shared database by all affected nations, thus improving data sharing and thalassemia management. In this paper, we propose a minimum requirement for establishing a genomic database in thalassemia based on the HVP database guidelines. We suggest using an existing platform recommended by HVP, the Leiden Open Variation Database (LOVD) (https://www.lovd.nl/). Adoption of our proposed criteria will assist in improving or supplementing the existing databases, allowing for better-quality services for individuals with thalassemia. Database URL: https://www.lovd.nl/., (© The Author(s) 2024. Published by Oxford University Press.)

Background: The revolutionary technology of smartphone-based retinal imaging has been consistently improving over the years. Smartphone-based retinal image acquisition devices are designed to be portable, easy to use, and cost-efficient, which enables eye care to be more widely accessible especially in geographically remote areas. This enables early disease detection for those who are in low- and middle- income population or just in general has very limited access to eye care. This study investigates the limitation of smartphone compatibility of existing smartphone-based retinal image acquisition devices. Additionally, this study aims to propose a universal adapter design that is usable with an existing smartphone-based retinal image acquisition device known as the PanOptic ophthalmoscope. This study also aims to simulate the reliability, validity, and performance overall of the developed prototype., Methods: A literature review has been conducted that identifies the limitation of smartphone compatibility among existing smartphone-based retinal image acquisition devices. Designing and modeling of proposed adapter were performed using the software AutoCAD 3D. For the proposed performance evaluation, finite element analysis (FEA) in the software Autodesk Inventor and 5-point scale method were demonstrated., Results: Published studies demonstrate that most of the existing smartphone-based retinal imaging devices have compatibility limited to specific older smartphone models. This highlights the benefit of a universal adapter in broadening the usability of existing smartphone-based retinal image acquisition devices. A functional universal adapter design has been developed that demonstrates its compatibility with a variety of smartphones regardless of the smartphone dimension or the position of the smartphone's camera lens. The proposed performance evaluation method generates an efficient stress analysis of the proposed adapter design. The end-user survey results show a positive overall performance of the developed universal adapter. However, a significant difference between the expert's views on the developed adapter and the quality of images is observed., Conclusion: The compatibility of existing smartphone-based retinal imaging devices is still mostly limited to specific smartphone models. Besides this, the concept of a universal and suitable adapter for retinal imaging using the PanOptic ophthalmoscope was presented and validated in this paper. This work provides a platform for future development of smartphone-based ophthalmoscope that is universal., (© 2024. The Author(s).)

Tractors are manufactured without air-conditioned cabins in Pakistan. This leads to thermal discomfort for tractor operators working under direct solar exposure. Therefore, this study aimed to design and install an air-conditioned cabin on a tractor. Experiments were undertaken to evaluate the installed cabin performance under two scenarios i.e., conventional (S-I) and enhanced (S-II) air distribution. Computational fluid dynamics (CFD) simulations were used to analyze airflow and calculate thermal comfort indices. The results showed that the air-conditioned cabin attained optimum thermal conditions under the enhanced air distribution scenario (S-II). In this scenario, the inside cabin temperature was an average of 27.4 °C, compared with 30.4 °C in S-I. The relative humidity remained similar in both scenarios, around 53 %. The temperature difference between the cabin and the ambient environment was 11.09 °C in S-II, aligning with the thermal comfort conditions outlined in ISO 14269-2. Furthermore, the CFD simulations showed a predicted mean vote (PMV) index of 0.61 and the percentage people dissatisfied (PPD) index of 26.5 %. These results also confirm the provision of optimum thermal conditions for operator inside the cabin. The simulations also demonstrated good agreement with experimental data, with a small difference in air temperature (2 °C) and relative humidity (5.8 %). In the light of these findings, this study recommends installation of air-conditioned cabin on tractors with enhanced air distribution (S-II) in Pakistan to improve thermal comfort of operators., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

Background: Colorectal tumor is a major cause of cancer morbidity and mortality both in USA and around the globe. Exposure to environmental toxicants such as toxic trace elements has been implicated in colorectal malignancy. However, data linking them to this cancer are generally lacking., Methods: Accordingly, the current study was to investigate the distribution, correlation and chemometric evaluation of 20 elements (Ca, Na, Mg, K, Zn, Fe, Ag, Co, Pb, Sn, Ni, Cr, Sr, Mn, Li, Se, Cd, Cu, Hg and As) in the tumor tissues (n = 147) and adjacent non tumor tissues (n = 147) of same colorectal patients which were analyzed by flame atomic absorption spectrophometry employing nitric acid-perchloric acid based wet digestion method., Results: On the average, Zn (p < 0.05), Ag (p < 0.001), Pb (p < 0.001), Ni (p < 0.01), Cr (p < 0.005) and Cd (p < 0.001) showed significantly higher levels in the tumor tissues compared with the non tumor tissues of patients, whereas mean levels of Ca (p < 0.01), Na (p < 0.05), Mg (p < 0.001), Fe (p < 0.001), Sn (p < 0.05) and Se (p < 0.01), were significantly elevated in the non tumor tissues than the tissues of tumor patients. Most of the elements revealed markedly disparities in their elemental levels based on food (vegetarian/nonvegetarian) habits and smoking (smoker/nonsmoker) habits of donor groups. The correlation study and multivariate statistical analyses demonstrated some significantly divergent associations and apportionment of the elements in the tumor tissues and non tumor tissues of donors. Noticeably, variations in the elemental levels were also noted for colorectal tumor types (lymphoma, carcinoids tumor and adenocarcinoma) and stages (I, II, III, & IV) in patients., Conclusion: Overall, the study revealed that disproportions in essential and toxic elemental concentrations in the tissues are involved in pathogenesis of the malignancy. These findings provide the data base that helps to oncologist for diagnosis and prognosis of colorectal malignant patients., Competing Interests: Declaration of Competing Interest All the authors have claimed that they have no conflict of interest., (Copyright © 2023 Elsevier GmbH. All rights reserved.)

Background: Acne is a serious skin problem that affects mostly adolescents. The topical and systematic therapies are effective but could lead to several side effects and the emergence of antibacterial resistance of the acne-causing bacteria. Plant resources have been used as traditional medicine for centuries and can be the alternative therapies for acne treatment. Antioxidants are compounds that can prevent or delay the oxidation of substrates when present in low concentrations. Antioxidants are usually involved in several mechanisms of action, including the inhibition of free radical generation, enhancement of the scavenging capacity against free radicals, and reducing power., Methods: In this study, three antioxidant assays, DPPH, ABTS, and FRAP were used to evaluate the antioxidant properties of the ethanolic extracts of five plant extracts (A. bilimbi, M. nigra, O. stamineus, P. granatum, and E. longifolia). Furthermore, the study aimed to identify the most potent plant extracts and their combination which could provide better antibacterial activities against acnecausing bacteria. Ethanolic extracts of A. bilimbi, O. stamineus, M. nigra, P. granatum, and E. longifolia were prepared by the Ultrasound-Assisted Extraction (UAE) technique. Their phytochemical contents were screened using several biochemical tests and GC-MS analysis., Results: The study found that only the extracts of P. granatum and O. stamineus exhibited good antioxidant activity using DPPH assay (82.37% and 81.72% μg/mL respectively) and in ABTS assay (87.25% and 88.85% μg/mL respectively); their observed FRAP values were 115.1667 ± 5.6182 and 41.3860 ± 2.4583 μg/mL, respectively. The preliminary antibacterial screening using the disc diffusion method showed that P. granatum and O. stamineus were the most potent extracts; hence, both extracts were combined at the ratios of 1:1, 1:2, and 2:1 to a total concentration of 400 mg/mL., Discussion: The antibacterial efficacy of the mixture was studied using the disc diffusion method and the MIC value was determined. Both S. aureus and S. epidermidis were sensitive to all the individual and combined extracts but C. acnes was resistant to all of them., Conclusion: The antibacterial activity of the combined extracts against S. aureus showed a synergistic effect at the ratio of 2:1 with the inhibitory zone diameter of 18.00 ± 1.00 mm and MIC value of 12.5 mg/mL; however, antagonistic effects were observed against S. epidermidis while no effect was noted against C. acnes. Therefore, all the selected plant extracts exhibited antibacterial activities against certain bacteria and their effects may be enhanced by combining the plant extracts., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Pain is a sensation a humans sense as a protective mechanism against physical injury. This sensation is closely related to inflammation. It ranges from mild to highly obnoxious. It is well-known that the levels of the inflammatory biomarker, C-reactive protein (CRP), increase manifold in acute inflammation and pain. Olive oil, known to have many phytochemicals, has been traditionally used to alleviate pain. Amongst major phenolic compounds in olive oil are oleuropein (OLE), hydroxytyrosol (HT), tyrosol, and oleocanthal. Whether the analgesic and anti-inflammatory properties in olive oil are due to any specific interections is not known. Therefore, this study aimed to elucidate the possible anti-inflammatory and anti-nociceptive properties in those major phenolic compounds by using molecular docking software MOE 2015, comparing the energy value and binding site of phenolic compounds to that of well-known synthetic non-steroidal anti-inflammatory drugs (NSAIDs) and phosphocholine. The docking experiment showed that all compounds could directly interact with CRP. Oleuropein had the most potent interaction with CRP (-7.7580), followed by indomethacin (-6.0775), oleocanthal (-5.5734), ibuprofen (-5.3857), phosphocholine (-4.3876), HT (-4.2782), and tyrosol (-4.2329). Interestingly, the present study found other phytochemicals in olive oil that can be exploited as potential, safe, and cost-effective lead compound(s) for analgesic and anti-inflammatory activity, as supported by its molecular docking data.