Demographic characteristics, laboratory features and complications in 346 cases of brucellosis: A retrospective study from Qatar.

Objectives: To study the epidemiology and laboratory findings and outcomes of human brucellosis in the state of Qatar. Methods: A retrospective study involving adult patients with a definitive diagnosis of brucellosis was conducted. Results: Of the 346 patients 299 were males. The mean age was 39.62 years. 120 patients had history of drinking raw milk and 116 had a history of contact with animals. Fever (89.9%) and myalgia (56.6%) were the most common presenting symptoms observed. Raised C-reactive protein level was the most frequent laboratory finding noted. Alanine aminotransferase and aspartate aminotransferase levels were raised to three times the normal in 39.6% and 37% of patients, respectively. Blood culture was positive in 72.8% whereas Brucella immunoglobulin G antibody and immunoglobulin M antibody titer was positive in 72.5% and 73.1% patients, respectively. Approximately 21.4% had focal involvement and osteoarticular (11.6%) involvement was the most frequently observed focal form. Doxycycline with rifampicin or gentamicin was the common regimen received. Relapse was seen in 7.2% patients. Conclusion: Human brucellosis continues to be a serious health issue in Qatar predominantly affecting healthy young adult men resulting in significant morbidity. Preventive measures and community awareness particularly among high-risk groups will help in decreasing the prevalence of the disease and its aftereffects.

Association Between Proton Pump Inhibitor Use and Extended-Spectrum Beta-Lactamase Urinary Tract Infection in Adults: A Retrospective Study.

Purpose: To study the association between proton pump inhibitor (PPI) use and the risk of urinary tract infection (UTI) caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL). Patients and Methods: A retrospective cross-sectional study was conducted between October 2018 and September 2019. Adults with ESBL-UTIs were compared to adults with UTIs caused by gram-negative bacteria (GNB) and those with UTIs caused by miscellaneous organisms. The association between ESBL infection and PPI use was assessed. Results: A total of 117 of 277 ESBL cases, 229 of 679 non-ESBL GNB controls, and 57 of 144 non-ESBL miscellaneous controls were exposed to PPIs within 3 months prior to admission. The univariate analysis indicated unadjusted odds ratio for PPI exposure with ESBL infection versus the GNB controls was 1.43 (95% CI 1.07-1.90, P = 0.015) while the odds ratio for PPI exposure with ESBL infection versus miscellaneous organisms was 1.10 (95% CI 0.73-1.67, P = 0.633) indicating positive association (PPI exposure increases risk of ESBL infection). Multivariate analysis revealed a positive association between ESBL infection and PPI use versus the GNB controls with an odds ratio of 1.74 (95% CI 0.91-3.31). While Esomeprazole was positively associated with ESBL infection, particularly compared with the miscellaneous group (adjusted OR 1.35, 95% CI 0.47-3.88), Lansoprazole was inversely associated (adjusted OR 0.48, 95% CI 0.18-1.24 and adjusted OR 0.40, 95% CI 0.11-1.41 for ESBL versus GNB controls and ESBL versus miscellaneous organisms, respectively). Conclusion: Exposure to PPIs in the preceding 3 months showed an association with increased risk of ESBL-UTI. While Esomeprazole showed a positive association, Lansoprazole had an inverse association for ESBL-UTI. Restricting the use of PPIs may be beneficial in the fight against antimicrobial resistance.

Epidemiology of urinary tract infection in adults caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae - a case-control study from Qatar.

Background: Community-acquired urinary tract infection (UTI) is the most common infection caused by extended-spectrum beta-lactamase (ESBL)-producing organisms. Aim: to estimate the prevalence of ESBL-UTI in adults and to identify potential risk factors that may predispose to ESBL-UTI. Methods: A retrospective study involving adult patients with UTI caused by ESBL-producing organisms was undertaken. Patients with UTI caused by non-ESBL-producing organisms represented the control group. Results: In total, 1100 UTI isolates were included in the study, 277 of which were ESBL positive. The prevalence rate was 25.2%. The mean age of patients was 55.87 years. On univariate analysis, prior history of UTI or ESBL-UTI, invasive urological procedure within preceding 3 months, hospital admission within preceding 3 months, and exposure to antibiotics were found to be significant risk factors for ESBL-UTI. On multi-variate analysis, use of cephalosporins [adjusted odds ratio (OR) 1.61, P=0.048], previous ESBL-UTI (adjusted OR 2.67, P<0.001), and invasive urological procedure in the preceding year (adjusted OR 1.61, P=0.022) were found to be independent risk factors for ESBL-UTI. Conclusions: In Qatar, the prevalence of ESBL-UTI in adults is modest. Recent exposure to antibiotics, previous ESBL-UTI and invasive urological procedures were found to be independent risk factors for ESBL-UTI.

Double-barrel adult congenital broncho-esophageal fistulae-images.

Congenital broncho-oesophageal fistulae (CBEF) are foregut developmental anomalies. They are formed due to the persistent attachment between the developing tracheal bud and the foregut in the embryo. They commonly present in young age and patients present with symptoms of recurrent respiratory tract infections and low body weight. Only one case of a double CBEF has been reported in literature so far. Here we present a congenital double barrel broncho-oesophageal fistula in a middle aged lady, which is a rare presentation. Definitive treatment involves division and repair of the fistula along with resection of the damaged portion of lung in select cases. We publish these images due to the rarity of a double fistula.

Hidden Nematode Causing Recurrent Pancreatitis: A Case Report.

Even though hepatobiliary ascariasis has been found to cause pancreatitis, it is rare in Qatar and other countries in the Middle East. In this report, we present a case of biliary duct ascariasis causing recurrent pancreatitis. A 46-year-old woman from the Philippines presented with recurrent clinical and biochemical features of acute pancreatitis and was found to have hepatobiliary ascariasis. She was successfully treated with endoscopic retrograde cholangiopancreatography (ERCP) and antihelminthic medication. Although hepatobiliary ascariasis as a cause of pancreatitis is rare, it should be considered in patients with recurrent pancreatitis without an obvious cause, especially in those from endemic areas or those who have visited endemic areas.

Perception and awareness of unintentional childhood injuries among primary caregivers of children in Vellore, South India: a community-based cross-sectional study using photo-elicitation method.

OBJECTIVE: We studied the primary caregivers' perception, and further, their awareness of unintentional childhood injuries in south India. METHODS: A cross-sectional study was conducted in the rural block of Kaniyambadi, Vellore, among 300 primary caregivers of children aged between 0 and 14 years. A semi-structured interview was conducted with the primary caregivers using a photo-elicitation method, with a visual depiction of ten injury risky scenarios for a child. Scoring was done to assess the perception of environmental hazards in these scenarios, and further, knowledge on the prevention of these injuries. An independent 't' test was done to elicit differences in mean scores and a multivariate regression analysis was applied to ascertain factors independently associated with the scores. RESULTS: Primary caregivers had adequate perception regarding risks posed to children in scenarios such as climbing trees (96.2%), playing near construction sites (96%), firecrackers (96.4%) and crossing unmanned roads with no traffic signals (94%). Knowledge of prevention was poor however, in the following scenarios: a woman riding a bicycle without safety features, with child pillion sitting behind bare foot and legs hanging by one side (72.6%); a child playing near a construction site (85.9%); and a child playing with plastic bags (88.3%). Overall, educational status of the primary caregiver and socioeconomic status were associated with poorer perception of risks and knowledge about unintentional childhood injuries and their prevention. CONCLUSIONS: Pragmatic community-based childhood interventions incorporated into existing programs, with a special focus on road traffic injuries, burns and suffocation need to be implemented in high-risk settings of rural populations in South India.

Growth and characterization of Cadmium Thiosemicarbazide Bromide crystals for antibacterial and nonlinear optical applications.

Semiorganic nonlinear optical crystals of Cadmium Thiosemicarbazide Bromide was grown by slow evaporation solution growth technique. The unit cell parameters were estimated by subjecting the crystals to single crystal X-ray diffraction. The grown crystals were subjected to Powder X-ray diffraction for analyzing the crystalline nature of the sample. FTIR studies reveal the functional groups and the optical characters were analyzed by UV-Vis spectral studies. Mechanical stability of the sample was assessed by Vicker's micro hardness test. The presence of surface dislocations was identified by chemical etching technique. Antibacterial study was carried out against ACDP declared harmful pathogens. SHG efficiency of CTSB crystal was tested using Nd: YAG laser and it was found to be ∼1.8 times that of potassium dihydrogen phosphate.

Growth and characterization of nonlinear optical crystal Bis Thiourea Zinc Acetate (BTZA) in the presence of L-Proline.

Single crystal of 2 mol% L-Proline doped Bis Thiourea Zinc Acetate (BTZA), a semi organic nonlinear optical material has been grown using slow evaporation technique. Good quality single crystal with dimension 11×7×3 mm(3) was harvested after 30 days. The influence of amino acid L-Proline was studied for 1, 2 and 3 mol% L-Proline doped BTZA using Kurtz and Perry powder second harmonic generation test. This was compared with pure BTZA which confirms the enhancement of second harmonic generation property of L-Proline doped BTZA. Better enhancement was found in 2 mol% L-Proline doping. The grown crystal was characterized using single crystal X-ray diffraction, Fourier Transform Infra Red spectroscopy (FTIR) analysis, UV-Visible absorption and thermogravimetric analysis.

Investigation on the influence of foreign metal ions in crystal growth and characterization of L-Alaninium Maleate (LAM) single crystals.

A Nonlinear Optical, good quality, single crystals of doped and undoped l-Alaninium Maleate (LAM) were grown by slow evaporation solution growth technique at room temperature. The lattice parameters were analyzed by single crystal X-ray diffraction technique. The identification of Cadmium ion in the doped crystals was done using the EDAX spectrum. The presence of functional group of the dopant with LAM molecule was studied using FTIR spectra. The results of UV-Vis study is used to compare the transparencies of the doped and undoped LAM crystals. The optical band gap energy of the grown crystal was also calculated. The relative second harmonic generation (SHG) efficiency measurement with KDP reference is used to find the incorporation of metal to l-Alaninium Maleate crystals and the parent material. Also the thermal stability of the grown crystals was studied by TGA/DTA spectrum. The mechanical stability of the grown crystals was confirmed through Vickers micro hardness study. By parallel plate capacitor technique, the dielectric response was studied over a wide range of frequencies at different temperatures. The various studies showed the incorporation of the impurity Cd(2+) into LAM crystals and the investigations indicated that the impurity played an important role in the changes of the spectral and structural properties of LAM crystals.

Growth and characterization of pure and KCl doped zinc thiourea chloride (ZTC) single crystals.

Potassium Chloride (KCl) as an additive is added into zinc thiourea chloride solution in a small amount (1M%) by the method of slow evaporation solution growth technique at room temperature to get a new crystal. Due to the doping of the impurities on the crystals, remarkable changes in the physical properties were obtained. The grown crystals have been subjected to different instrumentation methods. The incorporation of the amount of potassium and zinc in the crystal lattices has been determined by AAS method. The lattice dimensions have been identified from single crystal X-ray diffraction measurements. The presence of functional group for the grown crystals has been identified by FTIR analysis. The optical, thermal and mechanical behaviors have been assessed by UV-Vis, TG/DTA and Vickers hardness methods respectively. The presence of dislocations of atoms has been identified by etching studies.

Habit modification of bis-thiourea zinc chloride (ZTC) semi organic crystals by impurities.

Single crystals of bis-thiourea zinc chloride (ZTC) doped with metal ion (Li(+)) possess excellent nonlinear optical properties. These crystals were grown by slow evaporation solution growth technique. The effect of Li(+) dopant on the growth and properties of ZTC single crystal were investigated and reported. The grown crystals were crystallized in orthorhombic structure with non-centro symmetric space group Pn21a through the parent compound. The amount of dopant incorporated in the parent crystal was revealed by the inductively coupled plasma (ICP-OES) studies. The FT-IR spectroscopy study was done for finding and confirming the functional groups present in the compound. The UV-Visible spectral study was carried out to find the optical behavior and transparency nature of the grown crystal. TG/DTA measurements and Vickers microhardness measurements were traced to find out the thermal and mechanical stability of the grown crystals respectively. Using Nd:YAG laser, the Second harmonic generation (SHG) for the grown crystals were confirmed.

Effect of L-Valine on the growth and characterization of Sodium Acid Phthalate (SAP) single crystals.

Undoped and amino acid doped good quality single crystals of Sodium Acid Phthalate crystals (SAP) were grown by slow evaporation solution growth technique which are semiorganic in nature. The effect of amino acid (L-Valine) dopant on the growth and the properties of SAP single crystal was investigated. The single crystal X-ray diffraction studies and FT-IR studies were carried out to identify the crystal structure and the presence of functional groups in undoped and L-Valine doped SAP crystals. The transparent nature of the grown crystal was observed using UV-Visible spectrum. The thermal decomposition of the doped SAP crystals was investigated by thermo gravimetric analysis (TGA) and differential thermal analysis (DTA). The enhancement in the NLO property of the undoped and L-Valine doped SAP crystals using KDP crystal as a reference was studied using SHG measurements. Vickers micro hardness measurements are used for the study of mechanical strength of the grown crystals.

Effect of lithium chloride on spectral, optical, thermal and mechanical behaviour of bis thiourea zinc acetate crystals.

Single crystals of pure bis thiourea zinc acetate (BTZA) and lithium chloride (LiCl) doped BTZA have been synthesized and grown successfully from aqueous solutions by slow evaporation technique. The single crystals thus grown were characterized by different techniques such as single crystal XRD, AAS, FT-IR, UV-Vis, TG/DTA and SHG test. The single crystal XRD study proved that the dopant has not changed the structure of the parent crystal. The AAS study confirmed the presence of lithium in the doped crystal. The FTIR study ascertained the metal coordination of lithium chloride doped BTZA through thiourea. The optical behavior of the doped crystal has been examined by UV spectral analysis. Thermal studies TGA & DTA of the doped crystal have been investigated and found that the doped crystal is thermally more stable than the pure crystal. The SHG test using Nd: YAG Laser confirmed the NLO activity of the pure and doped crystal. The obtained results are presented and discussed.

Growth and characterization of pure and glycine doped cadmium thiourea sulphate (GCTS) crystals.

The pure and glycine doped cadmium thiourea sulphate (GCTS) single crystals were grown successfully by slow evaporation method at room temperature. The concentration of dopant in the mother solution was 1 mol%. There is a change in unit cell. The Fourier transform infrared spectroscopy study confirms the incorporation of glycine into CTS crystal. The doped crystals are optically better and more transparent than the pure ones. The dopant increases the hardness value of the material. The grown crystals were also subjected to thermal and NLO studies.