Antimicrobial and Anti-Inflammatory Potential of Euphorbia paralias (L.): a bioprospecting study with phytoconstituents analysis.

Objectives: The phytochemicals in the aerial parts of Euphorbia paralias (also known as Sea Spurge) and their anti-inflammatory and antimicrobial activities were investigated. Methods: The methanolic extract was characterized using GC-MS and HPLC techniques. The anti-inflammatory feature was estimated through a Human Red Blood Cell (HRBC) membrane stabilization technique, while the antimicrobial feature was evaluated by the disc diffusion agar technique, minimum bactericidal concentration, and minimum inhibitory concentration (MIC) via micro-broth dilution method. Results: The GC/MS results demonstrated the existence of various phytochemicals, such as n-hexadecenoic acid, cis-11-eicosenoic acid, and methyl stearate, recognized for their anti-inflammatory and antibacterial features. The similarity of the phytochemical composition with other Euphorbia species emphasizes the genus-wide similarity. The anti-inflammatory activity exhibited a noteworthy inhibitory effect comparable to the reference drug indomethacin. The extract's antimicrobial potential was tested against a range of microorganisms, demonstrating significant action against Gram-positive bacteria and Candida albicans. The quantification of total phenolics and flavonoids further supported the therapeutic potential of the extract. Conclusion: The methanolic extract from E. paralias emerges as a successful natural source of important active constituents with potential applications as anti-inflammatory and antimicrobial agents. This research provides a first step to valorize Euphorbia paralias insights as a source of worthwhile phytochemicals that have potential applications in the pharmaceutical industry.

Synergistic effect of nano-potassium and chitosan as stimulants inducing growth and yield of bird of paradise (Sterlitiza reginae L.) in newly lands.

The bird of paradise plant is a clumping tropical species native to South Africa. It is a dramatic plant with distinctive iridescent orange and midnight blue flowers that resemble an exotic bird peeking out from the broad leaves in autumn, winter and spring. An experiment was conducted during the two seasons of 2021 and 2022 at a private farm in Damanhour, Beheira Governorate, Egypt (31"°" 04 "°"N, 30"°" 47' °E) to study the effect different concentrations of nano-potassium and chitosan and their combinations on the bird of Paradise (Sterlitiza reginae). The experiment was conducted in a randomized complete block in a split-plot design with five replicates; nano-potassium was used at 0, 100, 150, and 200 mg/l and assigned to the main plots, whereas the sub-plots involved 0, 0.25, 0.50 and 0.75 g/l of chitosan. An increase in plant height and leaf length was recorded when the plants were treated with 200 mg/l nano-potassium and 0.75 g/l chitosan. Spraying plants with concentrations of 150 mg/l nano-potassium and 0.75 g/l chitosan is associated with the superiority of S. reginae plants in other traits, such as leaves wide, number of leaves/plant, days to flowering, number of inflorescence/plant, number of florets/inflorescence, stalk length and diameter, inflorescence weight, longevity of inflorescence, and flowering period, compared to the other treatments. We conclude that adding nano-potassium and/or chitosan to the bird of paradise plant leads to an improvement in terms of vegetative and yield characteristics under newly reclaimed lands.

Probable Causative Agents and Demographic Patterns of Encephalitis, Meningitis, and Meningoencephalitis in a Single Tertiary Care Center.

Introduction Encephalitis, meningitis, and meningoencephalitis present significant challenges in clinical management owing to their diverse etiologies and potential complications. A high suspicion index is critical for guiding treatment strategies and improving patient outcomes. Understanding the demographic characteristics and frequency of causes of these conditions is essential to deliver optimized care. Objective This study aimed to investigate epidemiological causes and relative outcomes, including mortality, based on cultures, laboratory investigations, and demographic factors among patients with encephalitis, meningitis, and meningoencephalitis in a Saudi Arabian tertiary care center. Methods A retrospective cross-sectional study was conducted at King Abdulaziz Medical City (KAMC) in Jeddah, Saudi Arabia. Data were collected from patients admitted between April 2016 and December 2022 who met the specified inclusion criteria. Results Among 233 patients, meningitis was the most prevalent diagnosis (65.77%), with bacterial agents being the predominant causative agents (79.74%). Higher mortality was significant with pediatrics <5 years and adults >60 years. Conclusion This study provides valuable insights into the epidemiology and clinical outcomes of central neurological infections based on a Saudi Arabian cohort. These findings underscore the importance of an accurate diagnosis and tailored management strategies. Further studies are warranted to enhance our understanding and to inform more predictable characteristics targeted in optimizing healthcare delivery for patients with such conditions.

Phase effects in zirconia catalysed glucose conversion to 5-hydroxy methylfurfural.

5-(hydroxymethyl)furfural (HMF) is a key biomass derived platform chemicals used to produce fuel precursors or additives and value-added chemicals, synthesised by the cascade isomerisation of glucose and subsequent dehydration of reactively formed fructose to HMF over Lewis and Bronsted acid catalysts respectively. Zirconia is a promising catalyst for such reactions; however, the impact of acid properties of different zirconia phases is poorly understood. In this work, we unravel the role of the zirconia crystalline phase in glucose isomerisation and fructose dehydration to HMF. The Lewis acidic monoclinic phase of zirconia is revealed to preferentially facilitate glucose isomerisation, while the nanoparticulate tetragonal phase possesses Brønsted acid sites which favour fructose dehydration. Synergy between both zirconia phases facilitates cascade HMF production, with both catalysts investigated as physical mixtures in batch and flow reactor configurations. Using a physical mixture of only 15 wt% m-ZrO2 with 85 wt% t-ZrO2 in either batch or packed bed reactor configuration is sufficient to reach equilibrium conversion of glucose for subsequent dehydration by the t-ZrO2 component. Under continuous flow, a six-fold increase in HMF production was obtained when operating with a physical mixture of m- and t-ZrO2 compared to that from a single bed of t-ZrO2.

Predictive value of optical coherence tomography angiography in management of diabetic macular edema.

BACKGROUND: Optical coherence tomography angiography (OCTA) is a relatively new extension of Optical coherence tomography (OCT) that generates non-invasive, depth-resolved images of the retinal microvasculature which allows for the detection of various features of diabetic retinopathy. OBJECTIVES: This study aimed to detect biomarkers that may predict an early anatomical response to the treatment of diabetic macular edema (DME) with intravitreal ranibizumab (IVR) by means of OCTA. PATIENTS AND METHODS: This prospective interventional study was undertaken on 111 eyes of 102 naïve participants who had diabetic macular edema; enrolled patients were evaluated by taking a complete ophthalmologic history, examination and investigations by use of a pre-designed checklist involving Optical Coherence Tomography Angiography. RESULTS: Regarding the best corrected visual acuity (BCVA) the Mean ± SD was 0.704 ± 0.158 preoperatively and 0.305 ± 0.131 postoperatively in good responder patients; and was 0.661 ± 0.164 preoperatively and 0.54 ± 0.178 postoperatively in poor responders. The central macular thickness (CMT) was 436.22 ± 54.66 µm preoperatively and 308.12 ± 33.09 µm postoperatively in good responder patients; and was 387.74 ± 44.05 µm preoperatively and 372.09 ± 52.86 µm postoperatively in poor responders. By comparing the pre injection size of the foveal avascular zone area (FAZ-A) in both groups, it found that the mean ± SD of FAZ-A was 0.297 ± 0.038 mm in good responder patients compared to 0.407 ± 0.05 mm in non-responder patients. The preoperative superficial capillary plexus (SCP) foveal vascular density (VD) was 24.02 ± 3.01% in good responder patients versus 17.89 ± 3.19% um in poor responders. The preoperative SCP parafoveal VD was 43.06 ± 2.67% in good responder patients versus 37.96 ± 1.82% um in poor responders. The preoperative deep capillary plexus (DCP) foveal VD was 30.58 ± 2.89% in good responder patients versus 25.45 ± 3.14% in poor responders. The preoperative DCP parafoveal VD was 45.66 ± 2.21% in good responder patients versus 43.26 ± 2.35% um in poor responders, this was statistically significant. CONCLUSION: OCTA offers an accurate measurement for VD in the macula as well as the FAZ-A which could be used to predict an early anatomical response of anti-VEGF treatment in DME.

Congenital trans-mesentric internal hernia: a rare cause of acute intestinal obstruction in adult.

Introduction and Importance: Internal hernia is responsible for 0.6-5.8% of all small intestinal obstructions. Only 8% of internal hernias are of the congenital trans mesenteric variant. Urgent surgical intervention should be considered in individuals who exhibit intestinal obstruction before the development of irreversible bowel ischemia and necrosis. Case Presentation: The authors report a 38-year-old male patient who presented to the emergency department with abdominal pain, distension, and vomiting for the last three days. After an explorative laparotomy, it was confirmed that there was a trans mesenteric hernia defect with strangulated distal ileal loops. End-to-end ileo-ileal anastomosis was done. Clinical Discussion: Early recognition and subsequent surgical treatment permit proper management and prevent complications. There should be a differential diagnosis. In this case, there is no prior history of abdominal surgery, and the patient presents with recurrent abdominal pain and intestinal obstruction. Conclusion: Early diagnosis and emergency laparotomy can save the intestine before gangrene, lowering morbidity and mortality, correcting the mesenteric defect to prevent recurrences, and enhancing clinical outcomes because many studies have shown that some cases are missed before radiological investigation. Laparotomy is still the method of choice for acute cases of incarceration with bowel obstruction, strangulation, and ischemia. The entire mesentery needs to be evaluated, and all mesenteric defects need to be sutured to prevent recurrence.

Assessment of left atrial function using two-dimensional speckle tracking echocardiography in cryptogenic stroke patients.

BACKGROUND: Cryptogenic cerebrovascular stroke can be defined as an ischemic stroke that lacks a clear cause, even after a thorough evaluation. It should be distinguished from the embolic stroke of undetermined source (ESUS), a subgroup that includes cardio-embolic sources. This study aims to assess left atrial function through two-dimensional speckle tracking echocardiography (2D-STE) to determine its potential association with cryptogenic stroke and its predictive value for subclinical atrial fibrillation (AF). Our prospective cohort study involved 62 patients with unexplained cerebrovascular stroke or TIA, regardless of gender. Following TEE assessments, 22 patients were excluded due to identified sources of cardio-embolism. The remaining 40 participants were clustered into Group I. Group II, consisted of 40 healthy individuals without significant medical history, served as a control group. Both groups underwent two-dimensional trans-thoracic echocardiography and speckle tracking echocardiography. RESULTS: LA dysfunction parameters exhibited significant differences between Group I and Group II. LV diastolic dysfunction, LAVI, LAEF, and LASr were notably affected in Group I. At the same time, LA diameter in the parasternal long-axis view (PLAX) displayed a significant difference with a p value of 0.001. Within Group I, 14 patients experienced AF episodes (Group Ia, 35%); while, the remaining 26 were categorized as Group Ib (65%). LV diastolic dysfunction displayed a p value < 0.011; while, LAVI, LAEF, and LASr exhibited considerable differences with p values < 0.0001. However, the LA diameter showed no significant variation between the two groups. LASr emerged as the most sensitive and specific parameter for predicting AF, with a cutoff point of ≤ 24.5% and a p value < 0.0001. LAEF showed a cutoff point of ≤ 40.5% and a p value of 0.011. Meanwhile, LAVI demonstrated the lowest sensitivity and specificity, with a mean cutoff point of ≥ 38.5 ml/m2 and a p value of 0.003. CONCLUSIONS: 2D-STE is crucial for assessing LA dysfunction as a potential cryptogenic stroke cause after TEE and ruling out cardio-embolism sources. LASr serves as a key LA cardiopathy indicator, even preceding AF. LASr independently poses an AF risk. While LAEF and LAVI are significant LA dysfunction parameters and AF predictors, they exhibit lower sensitivity and specificity than LASr.

Isolation and characterization of Streptococcus agalactiae inducing mass mortalities in cultured Nile tilapia (Oreochromis niloticus) with trials for disease control using zinc oxide nanoparticles and ethanolic leaf extracts of some medicinal plants.

BACKGROUND: Streptococcus agalactiae (Group B streptococcus, GBS) induces a serious infection that can harm not only aquatic life but also humans and other animals. In a fish farm in southern Egypt, Nile tilapia (Oreochromis niloticus) has developed an epidemic with clinical symptoms resembling piscine streptococcosis. RESULTS: Initial microscopic inspection of the affected fish brain and kidney indicated the presence of Gram-positive cocci. S. agalactiae was effectively isolated and identified using nucleotide homology of the 16S rRNA and species-specific PCR. The partial 16S rRNA sequence was deposited in the GenBank database at the NCBI and given the accession number MW599202. Genotyping using RAPD analysis indicated that the isolates in the present study belonged to the same genotypes and had the same origin. The challenge test, via immersion (9.2 × 107, 9.2 × 106, and 9.2 × 105 CFU/ml for 1 h) or intraperitoneal injection (4.6 × 107, 4.6 × 106, and 4.6 × 105 CFU/fish), elicited clinical symptoms resembling those of naturally infected fish with a mortality rate as high as 80%. The ability to create a biofilm as one of the pathogen virulence factors was verified. Zinc oxide nanoparticles and the ethanolic leaf extracts of nine medicinal plants demonstrated considerable antibacterial activities against the tested S. agalactiae strain with low minimum bactericidal concentrations (MBC) and minimum inhibitory concentrations (MIC). The ethanolic leaf extracts from Lantana camara and Aberia caffra showed potent antibacterial activity with MBC values of 0.24 and 0.485 mg/ml, and MIC values of 0.12 & 0.24 mg/ml, respectively. CONCLUSION: This study isolated S. agalactiae from O. niloticus mortalities in a fish farm in Assiut, Egypt. The pathogen persists in fish environments and can escape through biofilm formation, suggesting it cannot be easily eliminated. However, promising findings were obtained with in vitro control employing zinc oxide nanoparticles and medicinal plant extracts. Nevertheless further in vivo research is needed.

Implementation of the WHO surgical safety checklist in resource-limited Somalia: a new standard in surgical safety.

BACKGROUND: Surgical safety remains a critical global health concern, with complications from surgical procedures resulting in significant morbidity and mortality, particularly in low- and middle-income countries. The World Health Organization (WHO) Surgical Safety Checklist (SSC) has been shown to reduce surgical complications and mortality rates. However, its implementation and impact in resource-limited settings like Somalia remain understudied. This study aimed to evaluate the implementation of the WHO SSC in selected hospitals in Mogadishu, Somalia, and assess its impact on surgical safety practices. METHODS: A pre- and post-intervention study was conducted in 15 randomly selected hospitals in Mogadishu, Somalia. The intervention involved a comprehensive training program on the WHO SSC for surgical teams. Data on hospital characteristics, surgical details, and adherence to the SSC were collected over two periods: pre-intervention (April 12th to May 4th, 2024) and post-intervention (May 12th to June 3rd, 2024). The primary outcome was the adherence to the SSC, categorized as good (> 60%) or poor (≤ 60%). Descriptive statistics, McNemar's test, and binary logistic regression were used for data analysis. RESULTS: Adherence to the WHO SSC significantly improved post-intervention, with 98.8% of surgical cases demonstrating good adherence compared to 37% pre-intervention (p < 0.001). The mean adherence score increased from 51.6% (SD = 29.6) to 94.1% (SD = 8.2). Significant improvements were observed for most individual checklist items, including patient identity confirmation, surgical site marking, anesthesia machine checks, and pulse oximeter use (p < 0.001). Team dynamics and communication also improved significantly post-intervention. Hospital type, size, years of service, funding source, surgical department, surgery type, urgency, and staff numbers were associated with checklist adherence pre-intervention. CONCLUSION: The implementation of a comprehensive training intervention significantly improved adherence to the WHO Surgical Safety Checklist in resource-limited hospitals in Mogadishu, Somalia. The findings highlight the feasibility and effectiveness of the SSC in enhancing surgical safety practices, team communication, and patient outcomes in challenging healthcare environments. Tailored implementation strategies, ongoing training, and cultural adaptation are crucial for the successful adoption of the SSC in resource-constrained settings.

Urethral duplication associated with epispadias: Case report.

INTRODUCTION AND IMPORTANCE: Urethral duplication is a rare congenital urinary tract anomaly. Its association with male epispadias is extremely rare. Due to various anatomical types, patients with urethral duplication can have a wide range of clinical presentations. Managing epispadias associated with urethral duplication involves different techniques and one should identify the functional urethra before proceeding with the surgery. It is associated with better functional outcomes than bladder epispadias exstrophy. CASE PRESENTATION: We report a case of a 4-year-old male child presented with a complaint of urinary incontinence. After evaluation, he was diagnosed with Urethral duplication associated with penopubic epispadias. Epispadias repair with urethral advancement was done and the child had a smooth postoperative course. CLINICAL DISCUSSION: Both urethral duplication and epispadias are rare congenital urinary tract anomalies. Urethral duplication associated with epispadias is extremely rare. Patient clinical presentation varies from incontinence to incidental findings. The diagnosis of urethral duplication in epispadias patients is usually missed preoperatively and even intraoperatively. The type of procedure going to be done depends on the type of urethral duplication. Management of these patients is associated with good functional outcomes. CONCLUSION: Even though urethral duplication associated with epispadias is a rare congenital malformation, it should be carefully searched in male epispadias.

Chlorogenic Acid Plays an Important Role in Improving the Growth and Antioxidant Status and Weakening the Inflammatory Response of Largemouth Bass (Micropterus salmoides).

This experiment evaluated the function of chlorogenic acid (CGA) in the growth, health status, and inflammation of largemouth bass (Micropterus salmoides). Over eight weeks, CGA supplementation was designed at five levels: 0, 60, 120, 180, and 240 mg/kg. The 180 and 240 mg/kg CGA-supplemented groups showed significant improvements in the FBW, SGR, and WGR compared to the control group (0 mg/kg) (p < 0.05). All the CGA-supplemented groups exhibited a significant reduction in the FCR (p < 0.05), with the 180 mg/kg CGA group showing the lowest FCR. Nonetheless, there were no appreciable differences in the plasma concentrations of TP, ALT, or AST among the treatments (p > 0.05). Compared to the control group, the 180 mg/kg CGA group exhibited significantly lower TC and TG levels (p < 0.05). The ALP levels showed no significant differences from the control group (p > 0.05). In terms of antioxidant parameters, CGA supplementation considerably reduced the MDA content (p < 0.05) and increased the GSH levels, while decreasing the CAT, SOD, and GPx activity levels Meanwhile, CGA supplementation resulted in reduced mRNA levels of SOD, CAT, Nrf2, Keap1, and NF-κB compared to the control group. In contrast, the mRNA levels of GPx, IL-8, TLR2, and RelA were elevated in the liver. Our findings indicated that CGA supplementation improved the growth performance and antioxidant status and weakened the inflammatory response of largemouth bass. These findings suggest that CGA could be a valuable dietary supplement for enhancing the health and growth of this species.

Efficacy of adding ketamine to levobupivacaine in paravertebral block on acute and chronic pain in thoracotomy: a randomized controlled double-blinded trial.

Background: The inappropriate management of pain after thoracotomy results in serious complications. Several adjuvants have been added to the thoracic paravertebral block (TPVB) to enhance its effects. This work aimed to evaluate the effect of adding ketamine to TPVB on thoracotomy-related acute and chronic pain. Methods: This randomized controlled double-blinded trial included 60 patients scheduled for open thoracotomy. Patients were equally randomized into 2 groups: group K: received TPVB + 1 mL ketamine (50 mg). Group C (n = 30): received TPVB (19 mL of 0.5% levobupivacaine + 1 mL normal saline) as a control arm. Results: Group K exhibited a significant delay in requesting analgesia, required less morphine in the first 24 and 48 hours, and reported lower numerical rating scale at rest and at deep breathing at various time points compared with the control group. However, both groups were comparable in post-thoracotomy pain syndrome and the incidence of complications at 2 months and 3 months. Conclusions: Adding ketamine to TPVB resulted in better analgesia as demonstrated by significantly delayed time to first rescue analgesia, lower total amount of consumed opioid, and pain score without considerable effect on chronic pain and complications in patients undergoing thoracotomy.

Evaluation of the growth, enzymatic activity, electrolyte leakage, and phytoremediation efficiency of Conocarpus erectus under cadmium and lead stress.

Contamination of agricultural soil by heavy metals poses a significant threat to soil quality and crop yields. Using plants as a natural remediation approach attracts researchers' attention around the world. A 16-month pot experiment was conducted using Conocarpus erectus in a randomized complete block design. The growth, enzymatic activity, electrolyte leakage, and remediation potential were estimated under Cd nitrate]40 low (L), 60 medium (M), 80 high (H) mg/kg soil [and Pb nitrate]400 (L), 700 (M), 1,000 (H) mg/kg soil [applied individually and in combination. Conocarpus erectus demonstrated a good tolerance (over 70%) against lower and medium cadmium (Cd) and lead (Pb) levels and a medium resistance against high Cd and Pb levels, with a survival rate of 100% under all the treatments used. The most negative treatment on the growth traits and tolerance of C. erectus was (H) Cd and (H) Pb, which reduced plant height; chlorophyll index; dry weights of the leaves, stems, and roots; root length; and tolerance index of biomass and roots by 25.87%, 48.97%, 50.56%, 47.25%, 58.67%, 50.18%, 51.00%, and 50% in comparison to the respective control, consecutively. Relative to the control, all Cd and Pb applications increased polyphenol oxidase (PPO), peroxidase (POD), and catalase (CAT) activities, and the increment was parallel up to medium Cd and Pb levels and then decreased with their high levels but still higher than the control. Electrolyte leakage (EL) was upheaved by raising the levels of Cd and Pb, and it reached the maximum (52.79%) at the (H) Cd (H) Pb treatment. Cd and Pb in the leaves, stems, and roots were boosted by raising their levels in the treatments. Conocarpus erectus is considered a phytoextractor for the Cd levels used because the bioconcentration factor of the stem (BCFs) and the translocation factor (TF) of Cd were >1, and it is a suitable plant for Pb phytoextraction at (L) Pb, (M) Pb, and (M) Cd (M) Pb levels because its Pb BCFs and bioconcentration factor of the root (BCFr) were <1 and its Pb TF was >1. On the other hand, C. erectus is considered a phytostabilizator for Pb at (H) Pb, (L) Cd, (L) Pb, and (H) Cd (H) Pb levels because its Pb BCFs, BCFr, and TF were <1.

Infectious Coryza in Pennsylvania.

Infectious coryza (IC) is a respiratory disease of chickens, including pullets, layers, and broilers, caused by the bacteria Avibacterium paragallinarum (AP), which was previously known as Hemophilus gallinarum. IC classically causes production decreases and mortality in chickens, frequently paired with swelling of the sinuses, mucoid nasal discharge, and respiratory rales. Although IC is considered an endemic disease of chickens in California, it has been unusual to rare in commercial chickens in Pennsylvania. The last reported IC case in Pennsylvania was in 2002, involving broiler breeders. However, between December 2018 and December 2019, 68 farms were affected by IC in Pennsylvania, involving approximately 14 million birds. Several farms had multiple flocks affected. Most affected farms housed layer chickens (37/68), but a smaller number of broiler farms, pullet farms, and layer breeder farms have been affected. Ages of affected birds and duration of disease were variable between flocks, as were the severity of clinical signs, pathologic lesions, and rates of mortality. PCR testing has greatly aided and sped diagnostic efforts in addition to traditional bacterial culture. In eight layer cases and five broiler cases, bacterial culture of the sinus or choanal cleft proved unrewarding, whereas culture of trachea, air sacs, lungs, heart, or liver were diagnostic. Although cases of IC in commercial Pennsylvania poultry continue, they have been greatly reduced because of implementation of a successful vaccination program. In this case series report we detail epidemiologic, clinical, and pathologic aspects of this outbreak and discuss vaccination as a control measure of IC in the state of Pennsylvania.

Coriza infecciosa en Pensilvania. La coriza infecciosa (CI) es una enfermedad respiratoria de las gallinas, incluyendo pollas de reemplazo, gallinas de postura y pollo de engorde, causada por la bacteria Avibacterium paragallinarum (AP), que anteriormente era conocida como Hemophilus gallinarum. Clásicamente, la coriza infecciosa causa disminución en la producción y aumento de la mortalidad en los pollos, frecuentemente es acompañada de inflamación de los senos nasales, secreción nasal mucoide y estertores respiratorios. Aunque la coriza infecciosa se considera una enfermedad endémica en la avicultura en California, ha sido inusual o esporádica en las aves comerciales de Pensilvania. El último caso notificado de coriza infecciosa en Pensilvania ocurrió en el 2002 y afectó a reproductoras pesadas. Sin embargo, entre diciembre del 2018 y diciembre del 2019, 68 granjas se vieron afectadas por esta enfermedad en Pensilvania, lo que afectó a aproximadamente 14 millones de aves. Varias granjas tuvieron múltiples parvadas afectadas. La mayor'ia de las granjas afectadas albergaban gallinas de postura (37/68), pero un número menor de granjas de pollos de engorde, de pollas de reemplazo y de reproductoras de aves de postura se han visto afectadas. Las edades de las aves afectadas y la duración de la enfermedad variaron entre parvadas, al igual que la severidad de los signos cl'inicos, las lesiones patológicas y las tasas de mortalidad. Las pruebas de PCR han ayudado acelerado enormemente los esfuerzos de diagnóstico además del cultivo bacteriano tradicional. En ocho casos de ponedoras y cinco de pollos de engorde, el cultivo bacteriano de senos respiratorios o de la hendidura coanal resultó infructuoso, mientras que el cultivo de tráquea, alvéolos, pulmones, corazón o h'igado fueron de utilidad diagnóstica. Aunque la presentación de casos de coriza infecciosa en aves comerciales de Pensilvania continúa, se han reducido considerablemente gracias a la implementación de un programa de vacunación exitoso. En esta serie de reportes de casos, se detallan los aspectos epizootiológicos, cl'inicos y patológicos de este brote y se analiza la vacunación como medida de control contra la coriza infecciosa en el estado de Pensilvania.

Outcomes After Brexucabtagene Autoleucel Administered as a Standard Therapy for Adults With Relapsed/Refractory B-Cell ALL.

PURPOSE: On the basis of the results of the ZUMA-3 trial, brexucabtagene autoleucel (brexu-cel), a CD19-directed chimeric antigen receptor T-cell therapy, gained US Food and Drug Administration approval in October 2021 for adults with relapsed/refractory (R/R) B-cell ALL (B-ALL). We report outcomes of patients treated with brexu-cel as a standard therapy. METHODS: We developed a collaboration across 31 US centers to study adults with B-ALL who received brexu-cel outside the context of a clinical trial. Data were collected retrospectively from October 2021 to October 2023. Toxicities were graded per American Society for Transplantation and Cellular Therapy guidelines for cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). RESULTS: At the time of data lock, 204 patients had undergone apheresis and 189 were infused. Median follow-up time was 11.4 months. Forty-two percent of patients received brexu-cel in morphologic remission and would have been ineligible for participation in ZUMA-3. After brexu-cel, 151 achieved complete remission (CR), of which 79% were measurable residual disease (MRD) negative remissions. Median progression-free survival (PFS) was 9.5 months and median overall survival was not reached. Grade 3-4 CRS or ICANS occurred in 11% and 31%, respectively. In multivariable analysis, patients receiving consolidative hematopoietic cell transplantation (HCT; hazard ratio, 0.34 [95% CI, 0.14 to 0.85]) after brexu-cel had superior PFS compared with those who did not receive any consolidation or maintenance therapy. CONCLUSION: Similar to ZUMA-3, high rates of MRD-negative CR were observed after brexu-cel treatment for R/R B-ALL. The use of HCT as consolidation after brexu-cel resulted in improved PFS.

Epididymo-Orchitis Mimicking Malignancy Resulting From Intravesical Bacillus Calmette-Guerin Immunotherapy for Bladder Cancer: An Attempt to Understand Pathophysiology, Diagnostic Challenges, Patients' Implications and Future Directions.

This case report describes an 85-year-old patient who presented with painless, unilateral right testicular swelling of 2 months' duration. This raised the possibility of testicular cancer, especially given his recent treatment for bladder cancer, which included adjuvant intravesical bacillus Calmette-Guerin (BCG) therapy. This poses a diagnostic dilemma regarding tuberculosis (TB) of the testis, BCG complications or a true testicular malignancy. Biochemical markers and a computed tomography (CT) scan showed no evidence of malignancy or disseminated TB. A TB-ELISpot test was negative. An ultrasound of the testis revealed a hypoechoic soft tissue lesion measuring approximately 24 × 19 mm, with internal vascularity and calcifications, causing a bulge in the testicular capsule with probable extracapsular extension. Based on the clinical suspicion of a testicular tumor, a right inguinal orchidectomy was performed. Histopathologic examination revealed isolated tuberculous orchitis with focal epididymal involvement; the spermatic cord was not involved. Polymerase chain reaction (PCR) testing on the histological sample confirmed the presence of Mycobacterium bovis DNA. As a radical right orchidectomy had been performed, no abnormal tissue remained. Additionally, the CT scan showed no evidence of TB dissemination, and the patient was asymptomatic, so he was being closely monitored in the infectious disease clinic. Importantly, a urine culture became positive for TB, and he was started on antituberculosis medication. BCG-induced granulomatous epididymo-orchitis may rarely occur as a late complication following intravesical BCG therapy for superficial bladder cancer. In this case report, we attempted to understand the pathophysiology, diagnostic challenges, patient implications, and potential future research directions.

Novel pyridine isonicotinoyl hydrazone derivative: synthesis, complexation and investigation for decontamination of DR-81 from wastewater.

Herein, novel aroylhydrazone (E/Z)-N'-((3-methylpyridin-2-yl)methylene)isonicotinohydrazide ligand (MPIH) 3 and its Zn(ii)-MPIH complex 4 were synthesized and investigated to adsorb direct red 81 dye (DR-81) from aqueous media. MPIH was synthesized by the condensation reaction of isonicotinohydrazide with 3-methylpicolinaldehyde 2, then performed in a basic medium with zinc chloride to form Zn(ii)-MPIH complex. The synthesized MPIH ligand 3 and Zn(ii)-MPIH complex 4 were further characterized via proton nuclear magnetic resonance (1H NMR), 13C nuclear magnetic resonance, Fourier transform infrared spectroscopy (FT-IR), UV-visible, mass spectra analysis (EI MS), and elemental analysis. The synthesized MPIH ligand 3 and Zn(ii)-MPIH complex 4 were evaluated for their ability to decontaminate DR-81 from wastewater. The performance of MPIH ligand 3 to adsorb DR-81 from wastewater was lower than Zn(ii)-MPIH complex 4 over contact times of 180 minutes. The optimal dosage of the Zn(ii)-MPIH complex 4 was determined to be 1.0 g L-1 at pH 7, achieving 88.3% adsorption of 10 ppm DR-81 within 45 minutes. Thermodynamic analysis showed that the decontamination process was spontaneous and exothermic when using the fabricated Zn(ii)-MPIH complex 4. The kinetic parameters aligned well with the pseudo-second-order kinetics model, and the adsorption process was accurately described by the Freundlich isotherm. The adsorption data confirmed that the Zn(ii)-MPIH complex 4 is an effective adsorbent for DR-81 in aqueous solutions, demonstrating high stability, the ability to be recycled for up to seven cycles, and ease of regeneration.

The Intersection between Frailty, Diabetes, and Hypertension: The Critical Role of Community Geriatricians and Pharmacists in Deprescribing.

Background: Frailty is a clinical syndrome prevalent among the elderly, characterised by a decline in physiological reserves and increased susceptibility to stressors, resulting in higher morbidity and mortality. Diabetes and hypertension are common in frail older individuals, often leading to polypharmacy. In this narrative review, we aimed to evaluate the relationship between frailty, diabetes, and hypertension and to identify effective management strategies and future research directions. Methods: This narrative review was conducted using the Scopus, Medline, PubMed, Cochrane Library, and Google Scholar databases. Results: Frailty significantly impacts the management and prognosis of diabetes and hypertension, which, in turn, affects the progression of frailty. Managing these conditions often involves multiple drugs to achieve strict glycaemic control and blood pressure targets, leading to polypharmacy and associated morbidities, including orthostatic hypotension, falls, fractures, hypoglycaemia, and reduced medication adherence. Identifying frailty and implementing strategies like deprescribing can mitigate the adverse effects of polypharmacy and improve outcomes and quality of life. Despite the availability of effective tools for identifying frailty, many frail individuals continue to be exposed to complex treatment regimens for diabetes and hypertension, leading to increased hospital admissions, morbidity, and mortality. Conclusions: Managing diabetes and hypertension in the frail ageing population requires a multidisciplinary approach involving hospital and community geriatricians and pharmacists. This is important due to the lack of sufficient clinical trials dedicated to diabetes and hypertension in the context of frailty. Future large population studies are needed to assess the best approaches for managing diabetes and hypertension in frail individuals.

Bone Loss and Fractures in Post-Menopausal Women Living with HIV: A Narrative Review.

INTRODUCTION: Post-menopausal women living with Human Immunodeficiency Virus (WLHIV) face an increased risk of bone fractures due to the relationship between HIV-related factors and menopause. This narrative review aims to summarise the current knowledge about fracture risk among post-menopausal WLHIV in particular looking at hormonal changes, combined antiretroviral therapy (cART), lifestyle factors, and psychosocial implications. We also profiled a summary of the significant, recent studies of post-menopausal WLHIV residing in low-income countries (LIC). METHODS: A thorough search of the literature was performed across PubMed, Medline, Scopus, and Google Scholar, focussing on studies published between 2000 and 2024. Inclusion criteria entailed original research, reviews, and meta-analyses addressing bone mineral density (BMD), fracture incidence, and related risk factors in post-menopausal WLHIV. RESULTS: The review identified 223 relevant studies. Post-menopausal WLHIV exhibit significantly lower BMD and higher fracture rates compared to both HIV-negative post-menopausal women and pre-menopausal WLHIV. cART, particularly tenofovir disoproxil fumarate (TDF), contributes to reduced BMD. Menopausal status exacerbates this risk through decreased oestrogen levels, leading to increased bone resorption. Moreover, lifestyle choices such as smoking, alcohol consumption, and low physical activity are more prevalent in PWHIV, which further elevates fracture risk. Different psychosocial factors may make WLWHIV more vulnerable at this stage of their life, such as depression, isolation, stigma, and housing and nutritional issues. Women living in LICs face a variety of challenges in accessing HIV care. There are gaps in research related to the prevalence of osteoporosis and bone loss in post-menopausal WLHIV in LICs. CONCLUSION: Post-menopausal women living with HIV face a significantly higher risk of bone loss and fractures due to the combined effects of HIV and menopause. Antiretroviral therapy (particularly TDF), lifestyle factors, and psychosocial challenges exacerbate this risk. There is a need for careful selection of cART, hormone replacement therapy (HRT), and emerging treatments such as Abaloparatide. A holistic approach including lifestyle changes and psychosocial support is crucial to reduce fracture risk in WLHIV, especially in low-income countries.

National study comparing psychiatric presentations among migrants and citizens in Qatar.

Arab countries host 10 % of the global migrant population, yet research on the mental health of migrant workers within this region is notably lacking. Addressing this gap, our study marks the inaugural nationwide investigation into psychiatric conditions among migrant workers compared to native Qatari citizens in an inpatient setting. Employing a retrospective cohort methodology, we scrutinized psychiatric presentations among two cohorts: migrant workers (cohort 1) and Qatari nationals (cohort 2) admitted to psychiatric inpatient facilities in Qatar. Our sample comprised 150 migrant workers and 138 Qatari inpatients, with a predominance of males in both cohorts and mean ages around 34-35 years. The median length of hospitalization was 13 days for migrant workers and 14 days for Qatari patients. Qatari inpatients exhibited a higher prevalence of prior psychiatric history and comorbid physical conditions. The primary diagnosis upon discharge for approximately one-third of patients in both groups was schizophrenia spectrum and other psychotic disorders, with bipolar disorder representing roughly one-quarter of cases in each cohort. Notably, migrant workers demonstrated a higher incidence of depressive disorders, trauma, and stress-related conditions, while Qatari patients were more frequently diagnosed with substance use disorder and displayed aggressive behaviors.