Effect of Nutrition and Behavior Modification Program (NBMP) on maternal and neonatal outcomes among hyperglycemic mothers.

OBJECTIVE: Hyperglycemic mothers and their offspring are at increased risk of various maternal and neonatal complications such as macrosomia, future type 2 diabetes, and metabolic abnormalities. Early diagnosis and individualized dietary management, exercise, and emotional well-being are expected to reduce these risks. The study aims to identify the effect of the Nutrition and Behavior Modification Program (NBMP) on maternal and neonatal outcomes of hyperglycemic mothers. PATIENTS AND METHODS: A pre-experimental study was performed among 89 hyperglycemic mothers. Glycemic control at 28 and 36 weeks, weight gain during pregnancy, pre-eclampsia, pregnancy-induced hypertension (PIH), mode of delivery, duration of exercise, emotional well-being, neonates' birth weight, incidence of hypoglycemia, and NICU admission were compared among the study and control groups. The intervention group received an individualized NBMP from their diagnosis of hyperglycemia until delivery. RESULTS: The results showed a significant difference in blood glucose between the study periods and groups at p<0.05 as per repeated ANOVA. Also, diet scores had a significant influence on BMI and glycemic control at p<0.05. Logistic regression models, adjusted for potential confounders including baseline blood glucose, age, economic status, previous GDM, family history of DM as well as baseline BMI, diet score, physical activity, and maternal well-being score, indicated that the NBMP reduced the blood glucose and BMI significantly at p<0.05 in the study group. NBMP also reduced the risk of SGA/LGA and preterm/post-mature birth, as well as increased the exercise duration and emotional well-being of mothers. CONCLUSIONS: The study's conclusions draw attention to the possible roles that maternal wellness, physical activity, and diet may have in reducing risks for both hyperglycemic mothers and their newborns. The NBMP resulted in higher adherence to lifestyle changes. Further research on a larger sample of hyperglycemic mothers is recommended to expand the generalizability of the findings.

The wake of the triple epidemic (Tripledemic): does it emphasizes the COVID-19 vaccine as a routine immunization for children? - A cross-sectional study.

OBJECTIVE: Many countries, including the USA, are currently confronting a triple epidemic in children as COVID-19 cases increase and new strains emerge which urge COVID-19 vaccination for children. The Advisory Committee on Immunization Practices (ACIP) for the CDC unanimously approved the inclusion of the COVID-19 vaccine (C19V) in the recommended immunizations. As healthcare professionals (HCPs) and parents are significant players in changing the trend of the triple epidemic by giving the C19V, the present study was done to determine awareness and perception of HCPs and parents on the tripledemic and the need for inclusion of C19V in vaccination schedules for children. PATIENTS AND METHODS: A cross-sectional study was conducted among 400 HCPs and 200 parents to assess their knowledge and perception of tripledemic and the need for the inclusion of C19V. RESULTS: Noticeably, half of the participants had either recent personal (36.2%) or family (21.8%) exposure to some of the tripledemic like RSV, Flu, or COVID-19. On perceived awareness, 42% were concerned about tripledemic, and 35% thought that regular C19V may prevent or reduce tripledemic. Ironically, 11% were not willing to give C19V to their children. The logistic regression model for positive perception of tripledemic and regular C19V identified significant relationships with education (OR 2.19, CI 1.48-3.81), gender (OR 0.9, CI 01.02-2.63), recent personal or family exposure to any of the tripledemic (OR 0.239, CI 0.87-1.63) and presence of children in the family (OR 0.71, CI 1.4-1.96). The reason for favorable perception was preventing self and family from tripledemic. CONCLUSIONS: The findings may give insight to the policymakers for a strategic plan to include C19V in the routine schedule to combat the pandemic and tripledemic by improving herd immunity.

Effect of COVID-19 vaccination on influenza-associated respiratory infection (IARI): benefit or backfire.

OBJECTIVE: Undoubtfully, COVID-19 vaccine (C19V) has significantly changed the pandemic's trajectory positively. At the same time, reports of transient local and systemic post-vaccination reactions leave a concern about its unknown impact on common ailments. Its effect on IARI is unclear because the present IARI epidemic began immediately after C19V in the previous season. PATIENTS AND METHODS: A retrospective observational cohort study among 250 Influenza-associated respiratory infection (IARI) patients by a structured interview questionnaire was conducted with the comparison between 3 groups with 1 dose, 2 doses and 2 doses plus booster dose of C19V. The p<0.05 was considered significant in this study. RESULTS: Among samples 21.2% received one dose of the C19V, only 3.6% got Flu vaccination, 30% had ≥2 comorbidities such as diabetes (22.8%), hypertension (28.4%) and ionically, 77.2% were on chronic medications. Significant differences (p<0.05) were found between groups with duration of illness, cough, headache, fatigue, shortness of breath and hospital visits. The logistic regression analysis shows that the extended IARI symptoms and hospital visits were significantly high among Group 3 (OR=9.17, 95% CI=3.01-29.0) and the same trend remained significant after adjusting the incidence of comorbidities among samples, the chronic conditions (OR=5.13, 95% CI=1.37-14.91) and flu vaccination status (O=4.96, 95% CI=1.41-16.2). Also, 66.4% of the patients were indecisive about getting vaccinated further. CONCLUSIONS: It has been challenging to reach any definitive conclusions regarding the effects of C19V on IARI, conducting extensive, substantial population-based studies that integrate clinical and virological data from more than one season is absolutely required, despite the fact that the majority of the reported effects were mild and temporary.

Production and evaluation of antimycotic and antihepatitis C virus potential of fusant MERV6270 derived from mangrove endophytic fungi using novel substrates of agroindustrial wastes.

Among forty endophytic fungal isolates derived from the mangrove plant Avicennia marina, thirty-seven isolates (92.5 %) shown vary antimycotic activity against clinical Trichophyton, Microsporum, and Epidermophyton isolates. The hyperactive wild antagonistic strains Acremonium sp. MERV1 and Chaetomium sp. MERV7 were subjected to intergeneric protoplast fusion technique, and out of 20 fusants obtained, the fusant MERV6270 showed the highest antimycotic activity with the broadest spectrum against all dermatophytes under study. Solid-state fermentation (SSF) showed its superiority for antimycotic/antiviral metabolite production using cost-effective agroindustrial residues. Low-cost novel fermentation medium containing inexpensive substrate mixture of molokhia stalk, lemon peel, pomegranate peel, peanut peel (2:1:1:1) moistened with potato, and meat processing wastewaters (2:1, at moisture content of 60 %) provided a high antimycotic metabolite yield, 33.25 mg/gds, by the fusant MERV6270. The optimal parameters for antimycotic productivity under SSF were incubation period (4 days), incubation temperature (27.5-30 °C), initial pH (6), initial moisture level (60 %), substrate particle size (1.0 mm), and inoculum size (2 × 10(6) spores/gds), which elucidated antimycotic activity to 44.19 mg/gds. Interestingly, wild mangrove Acremonium sp. MERV1 and Chaetomium sp. MERV7 strains and their fusant MERV6270 showed significant inhibition of hepatitis C virus with viral knockdown percent of -82.48, -82.44, and -97.37 %, respectively, compared to the control (100 %), which open a new era in combat epidemic viral diseases.

Vitamin D level and Fok-I vitamin D receptor gene polymorphism in Egyptian patients with type-1 diabetes.

Many cellular, preclinical and observational studies support a role of vitamin D in pathogenesis of type-1 diabetes mellitus (DM). The vitamin D receptor (VDR) locus has been studied in different populations for association with susceptibility to immune-mediated diseases, but with inconsistent findings in type-1 DM. This study aimed to investigate vitamin D status in patients with type-1 DM. We examined the frequency of VDR Fokl (rs10735810) gene polymorphism, and its association with serum 25-hydroxyvitamin D (25(OH) D) level in Egyptian patients with type-1 DM. 132 children with type-1 DM and 40 age and sex matched healthy control subjects were studied. VDR Fokl polymorphism was assessed using polymerase chain reaction and restriction fragment length polymorphism (RFLP) analysis. Diabetic children demonstrated lower circulating levels of 25(OH) D than the controls (13.4 +/- 7.6 vs 32.1 +/- 3.8ng/ml) (P < 0.01). Patients with deficient 25(OH) D showed lower calcium levels and higher HbA1c% than those with sufficient levels (8.1 +/- 2.1 versus 9.1 +/- 1.6 mg/dl & 9.9 +/- 2.5 versus 8.1 +/- 1.4%, respectively (P < 0.05). There was no significant difference in the genotype distribution or the allele frequencies of VDR Fokl between patients and controls. The odds ratio (OR) was 1.08 (P = 0.76), and the 95% confidence interval (CI) ranged from 0.64-1.85. The diabetic carriers of the ff genotype showed low serum levels of 25(OH) D and calcium when compared with the carriers of the F allele (9.1 +/- 4.4 vs 13.1 +/- 7 and 13.9 +/- 6.09 ng/ml & 8.1 +/- 2.1 vs 9.1 +/- 1.1 and 9.3 +/- 1.2 mg/dl, respectively) (P < 0.05). In conclusion, 84.8% of children with type-1 DM have low circulating levels of 25(OH) D. These patients have poor glycemic control (56.06%) than those with sufficient levels of 25(OH) D. Fokl polymorphism of VDR gene is associated with vitamin D deficiency but has no significant role in susceptibility to type-1 diabetes.

Overproduction and biological activity of prodigiosin-like pigments from recombinant fusant of endophytic marine Streptomyces species.

Thirty-four endophytic marine Actinomycetes isolates were recovered from the Egyptian marine sponge Latrunculia corticata, out of them 5 isolates (14.7 %) showed red single colonies on yeast-CzAPEK plates. Isolates under the isolation code NRC50 and NRC51 were observed with the strongest red biomass. After application of protoplast fusion between NRC50 and NRC51 isolates, 26 fusants were selected and produced widely different amounts of prodigiosin-like pigments (PLPs) on different fermentation media. Among them fusant NRCF69 produced 79 and 160.4 % PLPs more than parental strains NRC50 and NRC51, respectively. According to the analysis of 16S rDNA sequence (amplified, sequenced, and submitted to GenBank under Accession no. JN232405 and JN232406, respectively), together with their morphological and biochemical characteristics, parental strains NRC50 (P1) and NRC51 (P2) were identified as Streptomyces sp. and designated as Streptomyces sp. NRC50 and Streptomyces sp. NRC51. This study describes a low cost, effective production media by using peanut seed broth, sunflower oil broth or dairy processing wastewater broth alone, or supplemented with 0.5 % mannitol that supports the production of PLPs by the Streptomyces fusant NRCF69 under study (42.03, 40.11, 36.7 and 47 g L(-1), respectively). PLPs compounds exhibited significant cytotoxic activities against three human cancer cell lines: colon cancer cell line (HCT-116), liver cancer cell line (HEPG-2) and breast cancer cell line (MCF-7) and antimycotic activity against clinical dermatophyte isolates of Trichophyton, Microsporum and Epidermophyton.

Cellulase production from agricultural residues by recombinant fusant strain of a fungal endophyte of the marine sponge Latrunculia corticata for production of ethanol.

Several fungal endophytes of the Egyptian marine sponge Latrunculia corticata were isolated, including strains Trichoderma sp. Merv6, Penicillium sp. Merv2 and Aspergillus sp. Merv70. These fungi exhibited high cellulase activity using different lignocellulosic substrates in solid state fermentations (SSF). By applying mutagenesis and intergeneric protoplast fusion, we have obtained a recombinant strain (Tahrir-25) that overproduced cellulases (exo-ß-1,4-glucanase, endo-ß-1,4-glucanase and ß-1,4-glucosidase) that facilitated complete cellulolysis of agricultural residues. The process parameters for cellulase production by strain Tahrir-25 were optimized in SSF. The highest cellulase recovery from fermentation slurries was achieved with 0.2% Tween 80 as leaching agent. Enzyme production was optimized under the following conditions: initial moisture content of 60% (v/w), inoculum size of 10(6) spores ml(-1), average substrate particle size of 1.0 mm, mixture of sugarcane bagasse and corncob (2:1) as the carbon source supplemented with carboxymethyl cellulose (CMC) and corn steep solids, fermentation time of 7 days, medium pH of 5.5 at 30°C. These optimized conditions yielded 450, 191, and 225 units/gram dry substrate (U gds(-1)) of carboxylmethyl cellulase, filter-paperase (FPase), and ß-glucosidase, respectively. Subsequent fermentation by the yeast, Saccharomyces cerevisiae NRC2, using lignocellulose hydrolysates obtained from the optimized cellulase process produced the highest amount of ethanol (58 g l(-1)). This study has revealed the potential of exploiting marine fungi for cost-effective production of cellulases for second generation bioethanol processes.

Genome shuffling of marine derived bacterium Nocardia sp. ALAA 2000 for improved ayamycin production.

Genome shuffling is a recent development in microbiology. The advantage of this technique is that genetic changes can be made in a microorganism without knowing its genetic background. Genome shuffling was applied to the marine derived bacterium Nocardia sp. ALAA 2000 to achieve rapid improvement of ayamycin production. The initial mutant population was generated by treatment with ethyl methane sulfonate (EMS) combined with UV irradiation of the spores, resulting in an improved population (AL/11, AL/136, AL/213 and AL/277) producing tenfold (150 µg/ml) more ayamycin than the original strain. These mutants were used as the starting strains for three rounds of genome shuffling and after each round improved strains were screened and selected based on their ayamycin productivity. The population after three rounds of genome shuffling exhibited an improved ayamycin yield. Strain F3/22 yielded 285 µg/ml of ayamycin, which was 19-fold higher than that of the initial strain and 1.9-fold higher than the mutants used as the starting point for genome shuffling. We evaluated the genetic effect of UV + EMS-mutagenesis and three rounds of genome shuffling on the nucleotide sequence by random amplified polymorphic DNA (RAPD) analysis. Many differences were noticed in mutant and recombinant strains compared to the wild type strain. These differences in RAPD profiles confirmed the presence of genetic variations in the Nocardia genome after mutagenesis and genome shuffling.

Keratinolytic activity from new recombinant fusant AYA2000, derived from endophytic Micromonospora strains.

Two different endophytic strains, ESRAA1997 and ALAA2000, were isolated from the Egyptian herbal plant Anastatica hierochuntica. The 2 strains produced alkaline serine protease and were identified based on their phenotypic and chemotypic characteristics as different strains of Micromonospora spp. Both strains grew and produced keratinase, using different keratinous waste substances as the sole source of carbon and nitrogen. In our study, the activity and properties of keratinase enzymes of the wild strains ESRAA1997 and ALAA2000 were altered by genetic recombination through protoplast fusion between them, leading to a potent keratinolytic fusant Micromonospora strain AYA2000 with improved properties (activity, stability, specificity, and tolerance to inhibitors). Using a mixture of yeast extract, peptone, and malt extract as a supplement to the bovine hair medium increased keratinase production by 48%, and addition of 1% glucose suppressed enzyme production by Micromonospora strain AYA2000. The enzyme was purified by ammonium sulphate precipitation and DEAE-cellulose chromatography followed by gel filtration. The molecular weight, estimated using SDS-PAGE, was 39 kDa. The enzyme exhibited remarkable activity towards all keratinous wastes used and could also adapt to a broad range of pH and temperatures, with optima at pH 11 and 60 °C. The enzyme was not influenced by chelating reagents, metal ions, or alcohols. These properties make AYA2000 keratinase an ideal candidate for biotechnological application.

Production and genetic improvement of a novel antimycotic agent, saadamycin, against dermatophytes and other clinical fungi from endophytic Streptomyces sp. Hedaya48.

As a part of our ongoing efforts towards finding novel antimycotic agents from marine microflora of the Red Sea, vanillin, 5,7-dimethoxy-4-p-methoxylphenylcoumarin and the new antimycotic compound saadamycin were isolated from endophytic Streptomyces sp. Hedaya48. The producing strain was isolated from the Egyptian sponge Aplysina fistularis and subjected to different UV irradiation doses. A mutant strain Ah22 with 10.5-fold (420 mg/l as compared to 40 mg/l produced by the parental strain) improved saadamycin production was isolated. Production of saadamycin from mutant Ah22 was enhanced to 2.26-fold (950 mg/l) and 2.38-fold (1000 mg/l) under optimized culture conditions in batch culture and bioreactors, respectively. Both saadamycin and 5,7-dimethoxy-4-p-methoxylphenylcoumarin exhibited significant antimycotic activity against dermatophytes and other clinical fungi.

Novel bioactive metabolites from a marine derived bacterium Nocardia sp. ALAA 2000.

Extracts of the Egyptian marine actinomycete, Nocardia sp. ALAA 2000, were found to be highly bioactive. It was isolated from the marine red alga Laurenica spectabilis collected off the Ras-Gharib coast of the Red Sea, Egypt. According to detailed identification studies, the strain was classified as a member of the genus Nocardia. The cultivation and chemical analysis of this species yielded four structurally related compounds namely, chrysophanol 8-methyl ether (1), asphodelin; 4,7'-bichrysophanol (2) and justicidin B (3), in addition to a novel bioactive compound ayamycin; 1,1-dichloro-4-ethyl-5-(4-nitro-phenyl)-hexan-2-one (4) which is unique in contain both chlorination and a rarely observed nitro group. The compounds were isolated by a series of chromatographic steps and their structures of 1approximately 3 secured by detailed spectroscopic analysis of the MS and NMR data whereas that of 4 was elucidated by single crystal X-ray diffraction studies. These compounds displayed different potent antimicrobial activity against both Gram-positive and Gram-negative bacteria as well as fungi with MIC ranging from 0.1 to 10 microg/ml.

Bioactive benzopyrone derivatives from new recombinant fusant of marine Streptomyces.

In our searching program for bioactive secondary metabolites from marine Streptomycetes, three microbial benzopyrone derivatives (1-3), 7-methylcoumarin (1) and two flavonoides, rhamnazin (2) and cirsimaritin (3), were obtained during the working up of the ethyl acetate fraction of a marine Streptomyces fusant obtained from protoplast fusion between Streptomyces strains Merv 1996 and Merv 7409. The structures of the three compounds (1-3) were established by nuclear magnetic resonance, mass, UV spectra, and by comparison with literature data. Marine Streptomyces strains were identified based on their phenotypic and chemotypic characteristics as two different bioactive strains of the genus Streptomyces. We described here the fermentation, isolation, as well as the biological activity of these bioactive compounds. The isolated compounds (1-3) are reported here as microbial products for the first time.

Essramycin: a first triazolopyrimidine antibiotic isolated from nature.

In the course of our screening program for new bio-active compounds, a novel triazolopyrimidine antibiotic, essramycin (1), was obtained from the culture broth of the marine Streptomyces sp., isolate Merv8102. Structure 1 was established by intensive NMR studies and by mass spectra. The compound is antibacterially active with MIC of 2 to 8 microg/ml against Gram-positive and Gram-negative bacteria, while it showed no antifungal activity. The fermentation and isolation, as well as the structure elucidation and biological activity of 1 are described.