Clinical Evaluation of Single Versus Repeated Micro-Osteoperforations During Orthodontic Canine Retraction: A Randomized Clinical Trial.

INTRODUCTION: In the majority of orthodontic premolar extraction cases, the canine retraction phase is the most laborious procedure. This randomized clinical trial aimed to assess the effect of single versus repeated micro-osteoperforations (MOPs) during orthodontic canine retraction. METHODS: In this split-mouth study, two equal groups of 18 patients who required maxillary first premolar extractions and fixed orthodontic therapy were randomly assigned (n=9). In Group I, MOPs were only performed once on one site before retraction, whereas in Group II, MOPs were performed on one site repeatedly once a month for four months. In both groups, the contralateral control sites received no MOPs. The canines were retracted using mini-screws and closed-coil nickel-titanium springs. Using the patients' 3D models, the primary outcome measure at four months was the amount of orthodontic canine distal movement. The amount of anchorage loss (AL), degree of molar rotation (MR) and canine rotation (CR), and degree of canine tipping (CT) were measured as the secondary outcomes. The comparison of mean changes in the primary and secondary outcomes between the groups was done using the independent sample t-test (p<0.05). RESULTS: The rate of canine retraction, degree of CT, and rotation were not significantly different between the two groups (p>0.05). Additionally, there were no statistically significant variations in the maxillary first MR and the degree of AL (p>0.05). CONCLUSIONS: When maxillary canine retraction was performed with a single and repeated regimen of MOPs, comparable levels of distal CR and tipping were observed, along with an identical minimal degree of MR and AL.

Cajanus cajan (L) Millsp seeds extract prevents rotenone-induced motor- and non-motor features of Parkinson disease in mice: Insight into mechanisms of neuroprotection.

ETHNOPHARMACOLOGICAL RELEVANCE: Cajanus cajan (L) Millsp (Fabaceae) seed decoction is used by traditional healers in Nigeria as nerve tonic, hence, could be beneficial in the treatment of Parkinson's disease (PD), a progressive and debilitating neurodegenerative disease that imposes great burden on the healthcare system globally. AIM OF THE STUDY: This study aimed at investigating the neuroprotective effect of ethanol seed extract of Cajanus cajan (CC) in the treatment of rotenone-induced motor symptoms and non-motor symptoms associated with PD. MATERIALS AND METHODS: To assess the protective action of CC on rotenone-induced motor- and non-motor symptoms of PD, mice were first pretreated with CC (50, 100 or 200 mg/kg, p.o.) an hour before oral administration of rotenone (1 mg/kg, p.o, 0.5% in carboxyl-methylcellulose) for 28 consecutive days and weekly behavioural tests including motor assessment (open field test (OFT), rotarod, pole and cylinder tests) and non-motor assessment (novel object recognition (NOR), Y-maze test (YM), forced swim and tail suspension, gastric emptying and intestinal fluid accumulation tests) were carried out. The animals were euthanized on day 28 followed by the collection of brain for assessment of oxidative stress, inflammatory markers and immunohistochemical analysis of the striatum (STR) and substantia nigra (SN). Phytochemicals earlier isolated from CC were docked with protein targets linked with PD pathology such as; catechol-O-methyltransferase (COMT), tyrosine hydroxylase (TH) and Leucine rich receptor kinase (LRRK). RESULTS: this study showed that CC significantly reduced rotenone-induced spontaneous motor impairment in OFT, pole, cylinder and rotarod tests in mice as well as significant improvement in non-motor features (significant reversal of rotenone-induced deficits discrimination index and spontaneous alternation behaviour in NORT and YM test, respectively, reduction in immobility time in forced swim/tail suspension test, gastrointestinal disturbance in intestinal transit time in mice. Moreso, rotenone-induced neurodegeneration, oxidative stress and neuroinflammation were significantly attenuated by CC administration. In addition, docking analysis showed significant binding affinity of CC phytochemicals with COMT, TH and LRRK2 receptors. CONCLUSION: Cajanus cajan seeds extract prevented both motor and non-motor features of Parkinson disease in mice through its antioxidant and anti-inflammatory effects. Hence, could be a potential phytotherapeutic adjunct in the management of Parkinson disease.

Morphogenetic identification of a new record Deudorix livia (Lepidoptera: Lycaenidae) in Assiut Governorate of Northern Upper Egypt.

Deudorix livia (Klug, 1834) (Lepidoptera: Lycaenidae) is one of the most serious lepidopteran insect pests attacking pomegranate fruit around the world, including Egypt (Assiut Governorate, Upper Egypt). To create an effective program (IPM) to control such harmful pests, accurate identification of the pest morphology and genetic structure is essential. Studies on the morphogenetics of this pest are scarce. So, the goal of this research is to identify it both morphologically and genetically. Pomegranate butterfly immature stages were collected from infested pomegranate fruits and reared in the laboratory until the adult's emergence. By using light and scanning electron microscopy, some morphological structures of males and females were studied. DNA was extracted from the legs of a pomegranate butterfly adult. Also, PCR was conducted by using the mitochondrial CO1 gene for sequencing and phylogenetic tests. The results show that the body scales are a mixture of dark and light gray on the dorsal side and white on the ventral side in both sexes. The average male body length (BL) was 11.674 ± 0.299 mm and was 11.458 ± 1.001 mm for the females. The wing venation is similar in both sexes. For the first time, a partial sequence of the mitochondrial CO1 gene in D. livia was deposited in GenBank (MW463927).

Impact of the COVID-19 Pandemic on Medical Product Procurement, Prices, and Supply Chain in Zimbabwe: Lessons for Supply Chain Resiliency.

BACKGROUND: The COVID-19 pandemic has disrupted global health supply chains including manufacturing, storage, and delivery of essential medicines, testing kits, personal protective equipment, and laboratory reagents. We sought to document how pandemic impacted the procurement, prices, and supply chain of medical products in Zimbabwe. METHODS: We conducted semistructured in-depth key informant interviews with 36 health system stakeholders in Zimbabwe involved in medicine procurement. Respondents included pharmacists, regulatory officers, and procurement and supply chain management professionals from public and private sectors. RESULTS: Before the COVID-19 pandemic, respondents described experiencing long-standing resource constraints, medicine shortages, foreign currency shortages, and supply chain inefficiencies. The pandemic exacerbated this situation due to supply constraints, export restrictions, medicine shortages, and movement restrictions that disrupted logistical and stock management systems. Competitive bidding and tendering processes experienced reduced participation by international suppliers. Significant price increases were initially observed among internationally shipped medicines and for personal protective equipment to cover additional freight costs. COVID-19 pandemic impacts were moderated by reduced patient demand and lower health services utilization, resulting in fewer supply shocks and less price volatility. Further, health system adaptations such as switching treatment regimens, modifying dispensing schedules based on stock availability, redistributing stock of medicines among facilities, and new service delivery models such as integrated outreach services helped ensure continued patient access to medicines. CONCLUSIONS: Our findings highlight the need for policies that ensure continuity in access to health services and medical products, even during a pandemic, by avoiding blanket restrictions on medical product exports and imports. Pooled procurement, especially at regional and global levels, with long-term service agreements may help achieve greater resiliency to supply and price shocks from supply chain disruptions. Interventions across manufacturing, trade, and regulatory policy and service delivery models are also needed for supply chain resiliency.

Scaling up numbers and competency of graduating medical and dental students in Nigeria: Need to improve medical trainers' competency in teaching.

Background: With the increasing medical brain drain in Nigeria, there is a need to train and graduate more doctors to fill in the gaps created to mitigate the effects. To meet this goal, the trainers need to evolve and have the competency to deliver quality training for many more enrollees in medical schools. Aim: This study aimed to gather information about the perception of medical teachers' need to obtain certification in medical education and what this will achieve in scaling up the competency and number of graduating medical doctors. Subjects and Methods: Medical teachers in Nigeria participated in this mixed (quantitative and qualitative) study. Four hundred medical consultants and teachers were randomly selected and sent a semi-structured pre-validated questionnaire; also, a panel discussion was conducted with six medical teachers with other special assignments in universities and postgraduate colleges. Quantitative data were analyzed using Statistical Package for the Social Sciences (SPSS) 24, differences in proportions were calculated using the Chi-square test, and P values <0.05 were considered significant. Results: Two hundred and thirty-eight (59.5%) participants completed the form, 63 (26.5%) had practiced for <5 years, and 114 (47.9%) had >10 years of practice experience. A majority of 168 (70.6%) were physician lecturers in federal or state universities, and 15.5% had obtained certifications of any kind in medical education. Over 80% perceived that medical education training should not be a prerequisite to teach, but a similar percentage believed that faculty medical education training can help scale up the training competency and the number of graduating medical doctors. Conclusion: To scale up the number and competency of graduating medical doctors, medical teachers need to acquire core teaching competency. The respondents and discussants believe that when these core teaching competencies have been fully developed, it will be easier to increase the number of medical students' enrollees, teach them their curriculum through innovations, and graduate them with improved competencies.

Thermal performance evaluation of bio-bricks and conventional bricks in residential buildings in Aswan city, Egypt.

From raw material extraction to final product disposal, the construction industry is integrally involved in every stage of the greenhouse gas emissions life cycle. One of the main causes of the climate catastrophe is the increasing use of polluting energy sources to power our homes and businesses. This massive problem of global warming has now forced countries to act. To further address sustainability, they seek to reduce energy consumption and CO2 emissions by adopting more sustainable materials. The current trend in scientific research is to use waste resources to improve the properties of various materials to exacerbate the problems of climate change because of the use of traditional building materials. Therefore, one of the most environmentally friendly alternatives to the standard procedure is the use of agricultural residues to improve the quality of building materials. This improvement will modify the thermal properties of building materials such as bricks, which will lead to an improvement in energy efficiency inside buildings, especially residential buildings. As a result, the research focused solely on simulating several bio-brick alternatives that had been discovered in earlier studies in order to test their viability in terms of increasing the energy efficiency of residential buildings in one of the hot cities. The study demonstrated that using bio-building materials can lower energy usage. In addition to saving energy in residential constructions, rice straw cement bricks and sugarcane bricks have operating efficiency rates of roughly 7% and 12%, respectively. All these advancements over conventional brick reduce greenhouse gas emissions and carbon dioxide.

Antibacterial and Anti-Biofilm Activities of Cinnamon Oil against Multidrug-Resistant Klebsiella pneumoniae Isolated from Pneumonic Sheep and Goats.

The primary objectives were to isolate and identify Klebsiella pneumoniae (K. pneumoniae), and determine the antimicrobial resistance patterns and biofilm formation abilities of the isolates. Additionally, the study aimed to investigate the antimicrobial and anti-biofilm effects of cinnamon oil against K. pneumoniae isolates. A cross-sectional study was conducted from March 2022 to April 2023 to collect 200 samples (including 156 nasal swabs and 44 lung specimens) from pneumonic sheep and goats admitted to the Veterinary Teaching Hospital of Zagazig University, Egypt. K. pneumoniae was isolated from a total of 72 (36%) samples, with 53 (73.6%) isolates recovered from nasal swabs and 19 (26.4%) from lung samples. Among the samples, 52 (36.9%) were from sheep and 20 (33.9%) were from goats. Antimicrobial susceptibility testing of the 72 K. pneumoniae isolates to 18 antimicrobials revealed that all isolates were resistant to ampicillin, amoxicillin/clavulanic acid, cefotaxime, ceftriaxone, tetracycline, colistin, fosfomycin, and trimethoprim/sulphamethoxazole. None of the isolates were resistant to amikacin, imipenem, and norfloxacin. Multidrug resistance (MDR) was observed in all K. pneumoniae isolates recovered from sheep and goats. The average MAR index was 0.71, ranging from 0.50 to 0.83. Regarding biofilm formation, among the K. pneumoniae isolates with a high MAR index (n = 30), 10% exhibited strong formation, 40% showed moderate formation, 43.3% displayed weak formation, and 6.7% did not form biofilms. Additionally, the biofilm-forming genes treC and fimA were present in all 28 biofilm-forming K. pneumoniae isolates, while the mrkA gene was detected in 15 (53.6%) of the 28 isolates. MDR K. pneumoniae isolates with strong biofilm formation abilities were treated with cinnamon oil at varying concentrations (100%, 75%, 50%, and 25%). This treatment resulted in inhibition zone diameters ranging from 35 to 45 mm. Cinnamon oil exhibited lower minimum inhibitory concentration and minimum bactericidal concentration values compared to norfloxacin for all isolates. Additionally, cinnamon oil significantly reduced the expression of biofilm-associated genes (treC, fimA, and mrkA) when compared to isolates treated with norfloxacin or untreated. In conclusion, this study identified a high level of MDR K. pneumoniae with strong and moderate biofilm formation abilities in pneumonic sheep and goats in Sharika Governorate, Egypt. Although cinnamon oil demonstrated potential antibacterial and anti-biofilm properties against K. pneumoniae, further research is required to investigate its effectiveness in treating K. pneumoniae infections in pneumonic sheep and goats.

Impact of the COVID-19 pandemic on the quality of medical products in Zimbabwe: a qualitative study based on key informant interviews with health system stakeholders.

OBJECTIVE: To explore the impact of the Coronavirus disease 2019 (COVID-19) pandemic on the quality of medical products in Zimbabwe, including market risks for substandard and falsified products and impacts on quality assurance activities. DESIGN: Qualitative study based on in-depth key informant interviews. SETTING: Health system stakeholders across the medical product supply chain in Zimbabwe. PARTICIPANTS: 36 key informants were interviewed between April and June 2021. RESULTS: We found that the COVID-19 pandemic disrupted quality assurance and regulatory activities of medical products in Zimbabwe, resulted in observations of poor-quality personal protective equipment (PPE) and other COVID-19-related products and led to increased risks to quality. Risks to quality due to COVID-19-related disruptions included increased layers of agents in the supply chain and an influx of non-traditional suppliers. COVID-19-related movement restrictions reduced access to health facilities and thus may have increased the usage of the informal market where smuggled and unregistered medical products are sold with less oversight by the regulator. Most reports of poor-quality medical products were for PPE, such as masks and infrared thermometers, used for the COVID-19 response. Besides these reports, many participants stated that the quality of essential medicines in the formal sector, not related to COVID-19, had largely been maintained during the pandemic due to the regulator's stringent quality assurance process. Incentives for suppliers to maintain quality to retain large donor-funded contracts, and the need for local wholesalers and distributors to comply with quality-related aspects of distribution agreements with global manufacturers of brand-name medical products, mitigated threats to quality. CONCLUSIONS: The COVID-19 pandemic presented opportunities and market risks for circulation of substandard and falsified medical products in Zimbabwe. There is a need for policymakers to invest in measures to safeguard the quality of medical products during emergencies and to build resiliency against future supply chain shocks.

Highly Durable Antibacterial Properties of Cellulosic Fabric via ß-Cyclodextrin/Essential Oils Inclusion Complex.

Essential oils (EOS), which naturally come from plants, have significant antibacterial properties against a variety of pathogens, but their high volatility and poor water solubility severely restrict their use in the textile industry. In this study, an inclusion complex based on ß-cyclodextrin (ß-CD)/EOS was prepared by two different simple methods: pad dry cure (method 1) and pad batch (method 2). A glyoxal crosslinking agent was used for the fixation of the inclusion complexes on the surface of the fabric. Lavender, rosemary, salvia, and lemon essential oils were applied. The structure of the ß-CD/EOs inclusion complex was investigated using scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), and weight gain (%), which indicated that the ß-CD/EOs were successfully deposited on cellulose-based fabric. The results demonstrated that ß-CD enhanced the oils' scent stability, with the advantage of exhibiting no major change in the tensile strength or permeability of cotton. Lavender oil had the highest stability scent with a value of 3.25, even after 30 days of evaluation. The antibacterial activity showed that EOS/ßCD-impregnated fabrics for method 1 had an inhibition zone ranging from 33 to 23 mm, while the inhibition zone for method 2 ranged from 39 mm to 29 mm, indicating that our treatment was able to control the growth of bacteria, even after five washing cycles. This study confirmed that the EOs/ßCD inclusion-complex-deposited cotton fabric might hold further promise for medical and hospital use.

Seroprevalence and risk factors of tropical theileriosis in smallholder asymptomatic large ruminants in Egypt.

Knowledge of the prevalence and epidemiological determinants of tropical theileriosis in large ruminants, particularly in the asymptomatic carrier, is crucial for designing and implementing effective host-specific control measures. This study aimed to estimate the seroprevalence of tropical theileriosis in asymptomatic cattle and water buffaloes and identify the potential risk factors of theileriosis in large ruminants raised under smallholder-production system in Egypt. A cross-sectional study was conducted in five districts of the Sharkia governorate from March 2019 to February 2020. In total, 350 serum samples were collected from cattle and water buffaloes under smallholder-production system and tested for Theileria annulata antibodies using the indirect antibody fluorescence test (IFAT). Data on species, host characteristics, presence of ticks, season, and districts were collected at sampling using a questionnaire. A multivariable mixed-effects logistic regression model was built to determine the potential risk factors associated with T. annulate seropositivity of the animals. The overall apparent seroprevalence of T. annulata in 350 tested animals was 70%. In the univariable analyses, cattle compared to buffaloes, younger animals compared to older ones, animals with ticks on their bodies, and warmer seasons were all associated with a higher likelihood of seropositive results in the study population while sex of the animals was not associated with seropositivity. The final multivariable model showed that animals with ticks on their bodies had 3.5× higher odds of seropositivity than those with no ticks (P < 0.001), and warmer seasons were associated with the higher odds of infection compared to winter (P = 0.003). The high seroprevalence of tropical theileriosis in the study region indicates that the disease is endemic among smallholders of large ruminants. The identified risk factors of T. annulata-seropositivity in asymptomatic carrier animals provides evidence-based guidance for adopting effective intervention measures.

Antibiotic utilization study in a teaching hospital in Nigeria.

Background: Antibiotics have been the bedrock of modern medical care, particularly bacterial infections. However, globally, antimicrobial resistance has become a well-recognized public health threat in recent years, and interventions to reduce its burden have been launched worldwide. Objectives: The present study evaluated antibiotic utilization in both hospitalized patients and outpatients in a University Hospital in Nigeria. Methods: In a 3 year retrospective study between January 2017 and December 2019, 246 case files of patients were selected for the study based on inclusion and exclusion criteria. In addition, the antibiotic consumption rate for hospitalized and outpatients was determined. Results: The total antibiotic consumption for hospitalized patients in this study was 260.9 DDD/100 bed-days, while the outpatient department's patients were 72.3 DDD/1000 inhabitants per day. Peptic ulcer disease was the most frequent indication for antibiotic use for outpatients, with the fluoroquinolones and macrolides being the most prescribed antibiotic class and antibiotic class with the highest DDD, respectively. The most frequent indication for antibiotic use for hospitalized patients was chronic kidney diseases, with the fluoroquinolones and second-generation cephalosporins being the most prescribed antibiotic class and antibiotic class with the highest DDD, respectively. DDD per 100 bed-days and DDD per 1000 patient-days were highest in 2018. The P values for the years were 0.019, 0.195 and 0.001 for 2017, 2018 and 2019, respectively. Conclusions: Our findings revealed irrationality in antibiotic use. Therefore, antimicrobial stewardship programmes should be implemented.

Datura stramonium abrogates depression- and anxiety-like disorders in mice: possible involvement of monoaminergic pathways in its antidepressant activity.

OBJECTIVES: Ethno-botanical surveys uncovered the use of Datura stramonium in the management of mental health abnormalities. Antidepressant- and anxiolytic-like activities of hydroethanol leaf extract of D. stramonium (HLDS) in mice and its possible mechanism of action were investigated in this study. METHODS: The hole-board test (HBT), open field test (OFT), elevated plus maze test (EPMT), and social interaction test (SIT) were used to investigate the anxiolytic-like activity while forced swim test (FST) and tail suspension test (TST) were employed for the antidepressant effect. Mice were pre-treated orally with purified water (10 mL/kg), bromazepam (1 mg/kg), fluoxetine (20 mg/kg) and D. stramonium (25, 50, 100 and 200 mg/kg). One hour post-treatment, mice were subjected to the various tests. RESULTS: In HBT, D. stramonium increased the head dips and sectional crossings turnover. D. stramonium increased the number of square crossed and rearings/assisted rearings in OFT. DS increased the time spent in open arms of EPM. In SIT, D. stramonium increased the frequency/duration of interactions. In FST and TST, D. stramonium decreased the duration of immobility which were reversed by doxazosin (α1 adrenoceptor antagonist) and ondasentron (5-HT3 receptor antagonist). CONCLUSIONS: HLDS has anxiolytic- and antidepressant-like activities through modulation of serotoninergic and adrenergic neurotransmissions.

Antibacterial and UV Protection Properties of Modified Cotton Fabric Using a Curcumin/TiO2 Nanocomposite for Medical Textile Applications.

Medical textiles are one of the most rapidly growing parts of the technical textiles sector in the textile industry. This work aims to investigate the medical applications of a curcumin/TiO2 nanocomposite fabricated on the surface of cotton fabric. The cotton fabric was pretreated with three crosslinking agents, namely citric acid, 3-Chloro-2-hydroxypropyl trimethyl ammonium chloride (Quat 188) and 3-glycidyloxypropyltrimethoxysilane (GPTMS), by applying the nanocomposite to the modified cotton fabric using the pad-dry-cure method. The chemistry and morphology of the modified fabrics were examined by Fourier transform infrared spectroscopy, energy-dispersive X-ray spectroscopy, and scanning electron microscopy. In addition, the chemical mechanism for the nanocomposite-modified fabric was reported. UV protection (UPF) and antibacterial properties against Gram-positive S. aureus and Gram-negative E. coli bacterial strains were investigated. The durability of the fabrics to 20 washing cycles was also examined. Results demonstrated that the nanocomposite-modified cotton fabric exhibited superior antibacterial activity against Gram-negative bacteria than Gram-positive bacteria and excellent UV protection properties. Moreover, a good durability was obtained, which was possibly due to the effect of the crosslinker used. Among the three pre-modifications of the cotton fabric, Quat 188 modified fabric revealed the highest antibacterial activity compared with citric acid or GPTMS modified fabrics. This outcome suggested that the curcumin/TiO2 nanocomposite Quat 188-modified cotton fabric could be used as a biomedical textile due to its antibacterial properties.

Sea urchin-like calcium borate microspheres and synergistic action with cholinesterase-inhibiting insecticides for ecofriendly Spodoptera littoralis control.

The development of nanoagrochemicals has attracted much attention in the last decade to overcome the recent agricultural and environmental challenges associated with the intensive usage of insecticides. Herein, nanostructured calcium borate materials with hierarchical sea urchin-like microspheres and microblocks have been synthesized by a facile hydrothermal method. The insecticidal activity of CaB2O4 and its synergistic combination with cholinesterase-inhibiting insecticides are explored against Spodoptera littoralis (S. littoralis) for the first time via a feeding bioassay protocol. The insecticidal efficacy of sea urchin-like microspheres (CB-A) is estimated to be LC50 = 207 mg L-1 which is two-fold higher than that of microblocks (CBM-A) with LC50 = 406 mg L-1 after eleven days of exposure. The synergistic combination of the CB-A sample with methomyl and chlorpyrifos increases the toxicity to 2.4 and 2.6-fold higher than that of the individual insecticides, respectively. Significantly, sea urchin-like CaB2O4 microspheres cause physical damage to the external insect's cuticle layer, which consequently enhances the uptake of organic insecticides. Our results revealed that calcium borate micro-/nano-structures can be employed as a multifunctional nanoagrochemical in various agricultural programs for S. littoralis control and decrease the usage of cholinesterase-inhibiting insecticides.

Sensitivity and specificity of piroplasm indirect fluorescent antibody test and PCR for Theileria annulata infection in clinically asymptomatic large ruminants using Bayesian latent class analysis.

There is limited information about the accuracy of molecular and serological diagnostic assays for tropical theileriosis in asymptomatic carrier large ruminants. This study has estimated the sensitivity (Se) and specificity (Sp) of PCR and an indirect fluorescent antibody test (IFAT) in the diagnosis of tropical theileriosis in cattle and buffaloes via a Bayesian latent class analysis (BLCA) framework. Blood samples were collected from 70 cattle and water buffaloes (Bubalus bubalis) raised under a smallholder production system in different Egyptian localities. T. annulata infection status was detected by PCR, and IFAT and the test results were subjected to BLCA without assuming the existence of a reference test. Our findings showed that the performance of PCR was superior to that of IFAT. PCR showed a higher Se [0.83 (95% PCI: 0.63-0.98)] in comparison to IFAT [0.72 (95% PCI: 0.68-0.75)]. Similarly, PCR showed a higher Sp [0.95 (95% PCI: 0.77-1.00)] than IFAT [0.82 (95% PCI: 0.80-0.84)]. Se and Sp of the two tests did not differ by species implying that the diagnostics' performance for T. annulata infection in bovines is the same regardless of the species under consideration. In conclusion, PCR outperforms IFAT in the detection of T. annulata infection and can thus be applied to routine control of tropical theileriosis in endemic situations where cattle and buffaloes are kept under traditional smallholder production systems.

Toll-like receptor 7 mRNA is reduced in hepatitis C-based liver cirrhosis and hepatocellular carcinoma, out-performs alpha-fetoprotein levels, and with age and serum aspartate aminotransferase is a new diagnostic index.

BACKGROUND: Hepatitis B and C viruses are leading causes of liver cirrhosis and hepatocellular carcinoma (HCC). Toll-like receptor 7 (TLR-7) has been implicated in the pathogenesis of HCC linked to hepatitis B. We hypothesised a role of leukocyte TLR-7 mRNA in hepatitis C related liver cirrhosis and HCC, using alpha-fetoprotein (AFP) and liver function tests as comparators. METHODS: We recruited 102 patients with HCV-related HCC, 97 with HCV-related liver cirrhosis and 60 healthy controls. Quantification of TLR-7 mRNA was performed using real-time PCR, AFP and routine LFTs by standard techniques. RESULTS: TLR-7 mRNA levels were significantly lower in HCC patients compared to cirrhotic patients and lower again in healthy controls (p < 0.001 for trend). In multivariate analysis, age, aspartate transaminase (AST), AFP, and TLR-7 mRNA were significant predictors of HCC. The ROCC/AUC for age, AST and TLR-7 mRNA were all between 0.64 and 0.78 (all P < 0.01), but for AFP was 0.57 (95% CI 0.48-0.65, P = 0.09). We derived an index score using age, AST and TLR-7 mRNA for the diagnosis of HCC. The ROCC/AUC for the index was superior to all three root indices in the prediction of HCC. The index linked significantly with the Tokyo and Vienna liver cancer staging systems, but not with those of the CLIP and Okuda systems, in distinguishing HCC from liver cirrhosis. CONCLUSION: The combination of TLR-7 mRNA levels with age and AST improves the performance of TLR-7 in HCC diagnosis, out-performs alpha-fetoprotein and predicts early HCC.

Equine pythiosis in Egypt: clinicopathological findings, detection, identification and genotyping of Pythium insidiosum.

BACKGROUND: Equine pythiosis is an emerging, devastating disease that is hard to treat. The tumour-like nodular skin masses grow rapidly and the outcome is generally fatal, and thus early diagnosis and intervention are important. OBJECTIVES: (i) To highlight the clinical, histological and haematological findings in pythiosis, and (ii) to evaluate the efficacy of direct sample multiplex-PCR targeting the single nucleotide polymorphisms within the ribosomal DNA region for detection and genotyping of Pythium insidiosum. ANIMALS: Two hundred and twenty horses including 204 Arabian and 16 draft horses were surveyed. METHODS: Case series study diagnosis was based on clinical, pathological and haematological findings typical of P. insidiosum infection, culture identification, immunohistochemical investigation and direct sample PCR. RESULTS: The affected horses (24 of 220, 10.91%) presented with unifocal or multiple lesions on the abdomen, limbs, chest, face and mammary gland. Cases commonly had a history of access to stagnant water, ponds and intentionally flooded rice fields. Most were pregnant mares (58.33%). Histopathology revealed granulomatous reaction, blood vessel endotheliosis, heavy infiltration of eosinophils in the dermal layer, multifocal necrosis and Splendore-Hoeppli phenomenon. Unlike direct microscopy (50%) and culture (91.6%), multiplex-PCR assay identified P. insidiosum (Clade II) in all tested samples. To the best of the authors knowledge, this is the first study determining a clade of P. insidiosum causing equine pythiosis in Egypt. CONCLUSIONS AND CLINICAL IMPORTANCE: Direct sample multiplex-PCR assay is a potential tool for the early and rapid diagnosis of equine pythiosis. It overcomes limitations associated with morphological identification and provides a definitive diagnosis.

Mechanical Circulatory Support in Patients with Cardiogenic Shock.

PURPOSE OF REVIEW: To provide a contemporary concise overview of the currently available mechanical circulatory support (MCS) devices and the emerging concepts in the management of cardiogenic shock (CS). RECENT FINDINGS: New classification of CS has emerged and is hoped to allow a unified approach to research and clinical management of CS. A number of MCS devices have also become available for clinical use in the last 2 decades. Those devices have different hemodynamic targets, provide various levels of support, and are associated with specific requirements and potential complications. Data on the utility of MCS in CS remains conflicting with randomized trials showing no benefit of MCS, and observational data suggesting an incremental value for MCS over medical therapy. However, the early use and escalation of MCS in a standardized approach do appear to provide a remarkable improvement in short-term outcomes of patients with CS. MCS devices afforded lifesaving treatment for many patients with CS. However, optimal utilization of such devices requires familiarity with their clinical data, and technical characteristics, and mandates their integration in an algorithmic team-based approach to CS.

Photocatalytic activity and antibacterial properties of linen fabric using reduced graphene oxide/silver nanocomposite.

Silver nanoparticles were in situ prepared on the surface of linen fabric coated by graphene oxide (GO). In the meantime, the reduction of silver nitrate on the GO-coated fabric led to the synthesis of reduced graphene oxide on the fabric. Two kinds of substrate (cotton and linen) were used. Both RGO/Ag and Ag/GO nanocomposites were added on cotton and linen fabrics through a conventional "pad-dry-cure" method. The chemistry and morphology of the coated surfaces were extensively characterized using Fourier-transformed infrared spectroscopy, energy-dispersive X-ray spectroscopy, and scanning electron microscopy. Resistivity measurements were used for assessing the conductivity. The UV protection properties and the photocatalytic activity of the coated fabrics against methylene blue dye were also investigated. The antibacterial activity was studied against Gram-positive S. aureus and B. subtilis and Gram-negative bacterial strains E. coli and P. aeruginosa by determining the zone of inhibition using the agar diffusion method. Methicillin-resistant Staphylococcus aureus (MRSA) has been responsible for many serious hospital infections worldwide. The fabrics showed superior antibacterial activity and successfully hindered the growth of pathogenic bacterial strains. This outcome suggested that both the RGO/Ag and Ag/GO nanocomposites-coated fabrics could be potentially applied in biomaterials and biomedical fields.