Prevalence and Antimicrobial Sensitivity Patterns of Uropathogens in Wad Medani, Sudan: A Three Years, Cross-Sectional Study.

Purpose: Urinary tract infections exert a significant negative impact on an individual's quality of life and cause significant economic and public health burdens. Therefore, this study was conducted to identify the common bacterial uropathogens associated with urinary tract infections in Wad Medani patients and their susceptibility to antibiotics. Patients and Methods: This was a cross-sectional study. All urine samples were collected from patients at Wad Medani and investigated at the Pathology Center for Diagnosis and Research, Faculty of Medicine, University of Gezira, Sudan, from the 1st of January 2021 to the 15th of October 2023. Results: A total of 2698 urine samples were analyzed during the three years study period, with a mean age of 45.29 ± 18.9 years. Among these patients, 1108 (41.8%) were positive for bacterial growth, and 888 (80.14%) were female. A total of 522 (47.1%) were gram positive bacteria (GPB), and 586 (52.9%) were gram negative bacteria (GNB). The most frequently isolated bacteria were S. aureus 42% (465/1108) and E. coli 38.5% (427/1108), while P. aeruginosa was less detected 3.4% (38/1108). Amikacin 91.5% was the most sensitive drug to isolated GPB, while cotrimoxazole 20.9% was the least sensitive drug. In particular, amikacin 94.1% (144/153) was the most sensitive drug to S. aureus, while cotrimoxazole 20.7% (80/386) was the least sensitive drug. Moreover, amikacin 91.5% was the most sensitive drug to the isolated GNB, while ampicillin 5.7% was the least sensitive drug. Notably, amikacin was the most sensitive drug to all the isolated GNB, and ampicillin was the least sensitive drug to all the isolated GNB. Conclusion: This study reported a moderate uropathogen isolation rate of 41.8%. S. aureus and E. coli were the most frequently isolated bacteria, most of which were from female patients. Remarkably, amikacin was the most sensitive drug to isolated GNB and GPB.

Role of Machine Learning and Artificial Intelligence in the Diagnosis and Treatment of Refractive Errors for Enhanced Eye Care: A Systematic Review.

A significant contributor to blindness and visual impairment globally is uncorrected refractive error. To plan effective interventions, eye care professionals must promptly identify people at a high risk of acquiring myopia, and monitor disease progress. Artificial intelligence (AI) and machine learning (ML) have enormous potential to improve diagnosis and treatment. This systematic review explores the current state of ML and AI applications in the diagnoses and treatment of refractory errors in optometry. A systematic review and meta-analysis of studies evaluating the diagnostic performance of AI-based tools in PubMed was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. To find relevant studies on the use of ML or AI in the diagnosis or treatment of refractive errors in optometry, a thorough search was conducted in various electronic databases such as PubMed, Google Scholar, and Web of Science. The search was limited to studies published between January 2015 and December 2022. The search terms used were "refractive errors," "myopia," "optometry," "machine learning," "ophthalmology," and "artificial intelligence." A total of nine studies met the inclusion criteria and were included in the final analysis. ML is increasingly being utilized for automating clinical data processing as AI technology progresses, making the formerly labor-intensive work possible. AI models that primarily use a neural network demonstrated exceptional efficiency and performance in the analysis of vast medical data, rivaling board-certified, healthcare professionals. Several studies showed that ML models could support diagnosis and clinical decision-making. Moreover, an ML algorithm predicted future refraction values in patients with myopia. AI and ML models have great potential to improve the diagnosis and treatment of refractive errors in optometry.

A comprehensive study of Al-Cu-Mg system reinforced with nano-ZrO2 particles synthesized by powder metallurgy technique.

More focus has recently been placed on enhancing the strength, elastic modulus, coefficient of thermal expansion (CTE), wear and corrosion resistance, and other qualities of aluminum (Al) alloys by varying the quantity of ceramics added for a range of industrial uses. In this regard, Al-4.2-Cu-1.6Mg matrix nanocomposites reinforced with nano-ZrO2 particles have been created using the powder metallurgy approach. The microstructure and particle size distributions of the produced powders were analyzed using a diffraction particle size analyzer, XRD, TEM, and SEM. To achieve good sinterability, the powders were compacted and sintered in argon. The sintered nanocomposites' mechanical, elastic, and physicochemical characteristics were measured. Additionally, the behavior of corrosion, wear, and thermal expansion were examined. The results showed a decrease in the particle sizes of the Al-Cu-Mg alloy by adding ZrO2 nanoparticles up to 45.8 nm for the composite containing 16 wt.% ZrO2. By increasing the sintering temperature to 570 °C, the densification of nanocomposites was enhanced. Also, the coefficient of thermal expansion and wear rate remarkably decreased by about 28 and 37.5% by adding 16 wt.% ZrO2. Moreover, microhardness yield, strength, and Young's modulus were enhanced to 161, 145, and 64%, respectively, after adding 16 wt.% ZrO2. In addition, increasing the exposure time was responsible for decreasing the corrosion rate for the same sample.

Comprehensive studies for evaluating promising properties of Cu/graphene/fly ash nanocomposites.

Copper (Cu)'s electrical conductivity makes it attractive for industrial usage. Due to its inferior mechanical characteristics, thermal expansion, and wear resistance, its applications are limited. This manuscript solves these issues while retaining its major feature, excellent electrical conductivity. In this regard, different quantities of graphene (Gr) and fly ash (FA) nanoparticles were combined with Cu in a planetary ball mill at 440 rpm for 20 h using powder metallurgy (PM). The microstructure of the generated powders was characterized using X-ray diffraction technique and transmission electron microscopy. The powders underwent compression and were then subjected to firing at three distinct temperature levels, reaching a maximum of 850 °C. In addition, an analysis was conducted on the microstructure, mechanical properties, wear resistance, thermal expansion behaviour, and electrical conductivity of the sintered samples. Based on the findings, the inclusion of a hybrid of Gr and FA ceramics effectively led to a reduction in particle sizes. The bulk density slightly decreases with the addition of hybrid ceramic while increasing with the rise in sintering temperature. The hybrid composited Cu/0.8 vol.% Gr/8 vol.% FA recorded an increase in the microhardness, ultimate stress, and Young's modulus of 25, 20, and 50%, respectively, relative to the Cu matrix. Furthermore, the wear rate and coefficient of thermal expansion for the same sample decreased by 67 and 30%, respectively. Finally, increasing the sintering temperature showed a clear improvement in the mechanical, electrical, and corrosion properties. Based on the results obtained, it can be concluded that the prepared hybrid nanocomposites can be used in power generation, power transmission, electronic circuits, and other applications.

Tuning biodegradability, bone-bonding capacity, and wear resistance of zinc-30% magnesium intermetallic alloy for use in load-bearing bone applications.

This work aimed to improve the rapid biodegradation, poor wear resistance properties, and lack of bioactivity of metallic biomaterials to be used in orthopedic applications. In this context, zinc-magnesium (Zn-Mg) alloy with successive contents of calcium silicate (CaSiO3) and silicon nitride (Si3N4) was prepared using powder metallurgy technique. After sintering, their phase composition and microstructure were investigated using the X-ray diffraction technique and scanning electron microscopy (SEM), respectively. Furthermore, their degradation behavior and ability to form hydroxyapatite (HA) layer on the sample surface after immersion in simulated body fluid (SBF) were monitored using weight loss measurements, inductively coupled plasma-atomic emission spectroscopy, and SEM. Moreover, their tribo-mechanical properties were measured. The results obtained showed that the successive contents of CaSiO3 were responsible for improving the bioactivity behavior as indicated by a good formation of the HA layer on the samples' surface. Additionally, ceramic materials were responsible for a continuous decrease in the released ions in the SBF solution as indicated by the ICP results. The tribology properties were significantly improved even after exposure to different loads. Based on the above results, the prepared nanocomposites are promising for use in orthopedic applications.

The Effect of Mono and Hybrid Additives of Ceramic Nanoparticles on the Tribological Behavior and Mechanical Characteristics of an Al-Based Composite Matrix Produced by Friction Stir Processing.

Friction stir processing (FSP) is an effective method for incorporating ceramic nanoparticles into metal matrix composites. This study investigated the effects of single and multiple additions of BN, VC, and SiC nanoparticles on the microstructure refinement and tribological behavior of an AA2024 alloy-based nanocomposite matrix fabricated by FSP. The results showed that adding ceramic nanoparticles, either singly or in combination, led to significant refinement of grain structure and improved wear resistance of the AA2024 alloy-based nanocomposite matrix. Additionally, the study found that combining BN, SiC, and VC nanoparticles produced the most effective effects on refining and reducing grain size. The microhardness behavior of the composite surface resulting from the hybrid particles showed a significant improvement, reaching 94% more than the base alloy. Overall, these results indicate that the multiple additions of ceramic nanoparticles by FSP are a promising approach to improve aluminum alloys' tribological behavior and mechanical properties.

Production of Hybrid Nanocomposites Based on Iron Waste Reinforced with Niobium Carbide/Granite Nanoparticles with Outstanding Strength and Wear Resistance for Use in Industrial Applications.

The main objective of this work is to recycle unwanted industrial waste in order to produce innovative nanocomposites with improved mechanical, tribological, and thermal properties for use in various industrial purposes. In this context, powder metallurgy (PM) technique was used to fabricate iron (Fe)/copper (Cu)/niobium carbide (NbC)/granite nanocomposites having outstanding mechanical, wear and thermal properties. Transmission electron microscopy (TEM) and X-ray diffraction (XRD) examinations were used to investigate the particle size, crystal size, and phase composition of the milled samples. Additionally, it was investigated how different volume percentages of the NbC and granite affected the sintered specimens in terms of density, microstructure, mechanical and wear properties, and coefficient of thermal expansion (CTE). According to the findings, the milled powders included particles that were around 55 nm in size and clearly contained agglomerates. The results showed that the addition of 4 vol.% NbC and 8 vol.% granite nanoparticles caused a reduction in the Fe-Cu alloy matrix particle sizes up to 47.8 nm and served as a barrier to the migration of dislocations. In addition, the successive increase in the hybrid concentrations led to a significant decrease in the crystal size of the samples prepared as follows: 29.73, 27.58, 22.69, 19.95 and 15.8 nm. Furthermore, compared with the base Fe-Cu alloy, the nanocomposite having 12 vol.% of hybrid reinforcement demonstrated a significant improvement in the microhardness, ultimate strength, Young's modulus, longitudinal modulus, shear modulus, bulk modulus, CTE and wear rate by 94.3, 96.4, 61.1, 78.2, 57.1, 73.6, 25.6 and 61.9%, respectively. This indicates that both NbC and granite can actually act as excellent reinforcements in the Fe alloy.

Differences in the Clinical Outcome of Ischemic and Nonischemic Cardiomyopathy in Heart Failure With Concomitant Opioid Use Disorder.

Heart Failure (HF) and Opioid Use Disorder (OUD) independently have significant impact on patients and the United States (US) health system. In the setting of the opioid epidemic, research on the effects of OUD on cardiovascular diseases is rapidly evolving. However, no study exists on differential outcomes of ischemic cardiomyopathy (ICM) and nonischemic cardiomyopathy (NICM) in patients with HF with OUD. We performed a retrospective, observational cohort study using National Inpatient Sample (NIS) 2018-2020 databases. Patients aged 18 years and above with diagnoses of HF with concomitant OUD were included. Patients were further classified into ICM and NICM. Primary outcome of interest was differences in all- cause in-hospital mortality. Secondary outcome was incidence of cardiogenic shock. We identified 99,810 hospitalizations that met inclusion criteria, ICM accounted for 27%. Mean age for ICM was higher compared to NICM (63 years vs 56 years, P < 0.01). Compared to NICM, patients with ICM had higher cardiovascular disease risk factors and comorbidities; type 2 diabetes mellitus (46.3 % vs 30.1%, P < 0.01), atrial fibrillation/flutter (33.5% vs 29.9%, P < 0.01), hyperlipidemia (52.5% vs 28.9%, P < 0.01), and Charlson comorbidity index ≥5 was 46.7% versus 29.7%, P < 0.01. After controlling for covariates and potential confounders, we observed higher odds of all-cause in-hospital mortality in patients with NICM (aOR = 1.36; 95% CI:1.03-1.78, P = 0.02). There was no statistical significant difference in incidence of cardiogenic shock between ICM and NICM (aOR = 0.86;95% CI 0.70-1.07, P = 0.18). In patients with HF with concomitant OUD, we found a 36% increase in odds of all-cause in-hospital mortality in patients with NICM compared to ICM despite being younger in age with less comorbidities. There was no difference in odds of in-hospital cardiogenic shock in this study population. This study contributes to the discussion of OUD and cardiovascular diseases which is rapidly developing and requires further prospective studies.

Trends in incidence and clinical outcome of non-ST elevation myocardial infarction in patients with amyloidosis in the United States, 2010-2020.

Study objective: To assess temporal changes in clinical profile and in-hospital outcome of patients with amyloidosis presenting with non-ST elevation myocardial infarction, NSTEMI. Design/setting: We conducted a retrospective observational study using the National Inpatient Sample (NIS) database from January 1, 2010, to December 31, 2020. Main outcomes: Primary outcome of interest was trend in adjusted in-hospital mortality in patients with amyloidosis presenting with NSTEMI from 2010 to 2020. Our secondary outcomes were trend in rate of coronary revascularization, and trend in duration of hospitalization. Results: We identified 272,896 hospitalizations for amyloidosis. There was a temporal increase in incidence of NSTEMI among patients aged 18-44 years from 15.5 % to 28.0 %, a reverse trend was observed in 45-64 years: 22.1 % to 17.7 %, p = 0.043. There was no statistically significant difference in rate of coronary revascularization from 2010 to 2020; 16.3 % to 14.2 %, p = 0.86. We observed an increased odds of all-cause in-hospital mortality in patients with NSTEMI compared to those without NSTEMI (aOR = 2.2, 95 % CI: 1.9-2.6, p < 0.001) but there was a decrease trend in mortality from 21.5 % to 11.3 %, p = 0.013 for trend. Hospitalization duration was also observed to decreased from 14.1 days to 10.9 days during the study period (p = 0.055 for trend). Conclusion: In patients with amyloidosis presenting with NSTEMI, there was increased incidence of NSTEMI among young adults, a steady trend in coronary revascularization, and a decreasing trend of adjusted all-cause in-hospital mortality and length of hospitalization from 2010 to 2020 in the United States.

Ultralight Functionally Graded Hybrid Nanocomposites Based on Yttrium and Silica-Reinforced Mg10Li5Al Alloy: Thermal and Tribomechanical Properties.

Despite the amazing properties of lightweight Mg10Li5Al alloy, its use in industrial applications is highly limited due to its low mechanical properties, wear resistance, and coefficient of thermal expansion (CTE). In this context, this work aimed to improve the above properties without sacrificing the important benefit of this alloy being lightweight. Therefore, function grade composites (FGCs) were prepared based on the Mg10Li5Al alloy reinforced by yttrium (Y) and silica fume using the powder metallurgy technique. Then, the nanocomposite's microstructure, mechanical properties, artificial aging, wear resistance, and thermal expansion were examined. The results indicated that the precipitation (MgAlLi2), softening (AlLi2), and Mg24Y5 phases were formed in high-reinforced samples during high-energy milling. Furthermore, the addition of reinforcements accelerated the decomposition from the MgAlLi2 phase to the Al-Li phase (softening point). For the layer containing the highest reinforcement content, microhardness, strength, and Young's modulus improved up to 40, 22.8, and 41%, respectively, due to the combined effect of the high strength of silica fume and the dispersion strengthening Mg24Y5 phase. Meanwhile, the same sample exhibited a remarkable improvement in wear rate and the CTE value to about 43 and 16.5%, respectively, compared to the non-reinforced alloy.

Investigating the Mechanical Properties and Durability of Asphalt Mixture Modified with Epoxidized Natural Rubber (ENR) under Short and Long-Term Aging Conditions.

Modifiers such as fibers, fillers, natural and synthetic polymer extenders, oxidants and anti-oxidants, and anti-stripping agents are added to produce modified asphalt. However, polymers are the most widely utilized modifiers to enhance the function of asphalt mixtures. The objective of this research was to evaluate the mechanical properties and durability of epoxidized natural rubber (ENR)-modified asphalt mix under short- and long-term aging conditions. The physical and rheological characteristics of the base asphalt and ENR-modified asphalt (ENRMA) were tested. In order to evaluate the mechanical properties and durability of the modified mixtures, the resilient modulus of the ENR-asphalt mixtures under unaged, and short- and long-term aging conditions at various temperatures and frequencies was obtained. Furthermore, the resistance to moisture damage of asphalt mixtures was investigated. The findings showed that the stiffness of the ENR-asphalt mixes increased because of the mutual influence of short- and long-term aging on the mixes. In addition, ENR reduced the susceptibility to moisture damage. The stiffness of the mixes was influenced by the temperature and frequencies. By using mathematical modelling via the multivariable power least squares method, it was found that temperature was the dominant factor among all other factors. The results suggested that the durability of asphalt pavements is improved by using ENR.

A retrospective study examining the clinical significance of testing respiratory panels in children who presented to a tertiary hospital in 2019.

Background. Respiratory tract infections are a leading cause of hospital visits in the paediatric population and carry significant associated morbidity and mortality in this population. The introduction of respiratory panel testing has been said to guide clinicians in the overall management of patients. Methods. We conducted a retrospective study examining all respiratory panels carried out in our hospital during 2019 on paediatric patients. Patients included were those who had symptoms indicative of respiratory infections who presented acutely, including those with chronic respiratory conditions. A total of 188 respiratory panel results were obtained along with collected patient data. These were analysed using SPSS V. 25.0 to get the below mentioned results. Results. The majority (76.6 %) of patients were less than 3 years with 59 % of total population being males. The majority (80.9 %) had mild clinical severity score. The most common pathogen that was detected on the respiratory panel was Enterovirus Human Rhinovirus spp, followed by the influenza viruses. Only four cases were positive for bacterial pathogens (two Mycoplasma pneumoniae , one Bordetella pertussis and one Chlamydia pneumoniae ), which accounts for 2.1 % of all panels analysed. The significance of respiratory panels in influencing treatment were analysed in the forms of change of management plans before and after results of respiratory panels. This was observed in 14.4 % of patients who were not on any empiric medication and then based on panel results were started on medications, as well as 11.7 % who were on medications already, and the medications were altered based on the result of the panel (Chi square P=0.057). This was mainly seen with cases of influenza A H1N1 patients and to a lesser extent, Mycoplasma pneumonia. Conclusion. The use of respiratory panels in our hospital had little impact on patient care and management. The main organisms that influenced clinician decision in treatment were influenza A viruses and bacterial organisms ( Mycoplasma pneumoniae , Chlamydia pneumoniae and Bordetella pertussis ). Other than that, the use of clinical judgement proved more beneficial. We recommend use of specific testing for these organisms rather than the whole panel as case to case bases, which would be more cost-effective and consistent with patient management.

Tobacco Use and Exposure to Environmental Tobacco Smoke amongst Pregnant Women in the United Arab Emirates: The Mutaba'ah Study.

Self-reported tobacco use is high in the male adult Emirati population (males ~36% vs. females ~3%); however, there are minimal data on tobacco use or exposure to environmental tobacco smoke (ETS) during pregnancy in the United Arab Emirates (UAE). This study investigated the prevalence of, and factors associated with, tobacco use and exposure to environmental tobacco smoke (ETS) amongst pregnant women in the UAE. Baseline cross-sectional data were analysed from the Mutaba'ah Study. Expectant mothers completed a self-administered questionnaire collecting sociodemographic information, maternal tobacco use, and ETS exposure during antenatal visits at three hospitals in Al Ain (UAE; May 2017-February 2021). Amongst 8586 women included in the study, self-reported tobacco use during pregnancy was low (0.7%), paternal tobacco use was high (37.9%), and a third (34.8%) of expectant mothers were exposed to ETS (28.0% at home only). Pregnant women who were employed (adjusted odds ratio (aOR): 1.35, 95% confidence interval (CI): 1.19-1.52), with childbirth anxiety (aOR 1.21, 95% CI 1.08-1.36), and with an increased number of adults living in the same household (aOR 1.02 95% CI 1.01-1.03) were independently more likely to be exposed to ETS. Pregnant women with higher education levels (aOR 0.84, 95% CI 0.75-0.94) and higher gravidity (aOR 0.95, 95% CI 0.92-0.99) were less likely to be exposed to ETS. Public health efforts targeting smoking cessation amongst husbands and promoting smoke-free homes are warranted to help reduce prenatal ETS exposure in the UAE.

Surgeons preferences in descemet membrane endothelial keratoplasty (DMEK).

AIM: To explore the attitudes, preferences, and barriers of DMEK among corneal specialists in Saudi Arabia. METHOD: An anonymous survey was sent through an online platform to members of the Saudi Ophthalmological Society. The survey was designed to capture data covering: demographic data, practice patterns of keratoplasty techniques, DMEK technique preferences, barriers, and facilitators to performing DMEK. RESULTS: Thirty-five (33% response rate) surgeons participated in the questionnaire. Sixty-eight percent were in practice for less than or equal to 10 years. Thirteen surgeons were performing DMEK. Participating in any training capacity was observed among surgeons who performed DMEK (92%). The main selection criteria for this procedure were patients with normal anterior chamber anatomy (77%). The main barrier against DMEK adoption among surgeons who do not perform the procedure was the lack of experience (91%). Strategies to help begin performing DMEK were eye banks support (prepared grafts, backup tissue for inadvertent loss), access to wet-lab training courses, and higher surgical volume. CONCLUSION: DMEK is not highly performed among corneal specialists in Saudi Arabia; however, there is evident interest in adopting this technique. Strategies toward filling the gap of lacking experience would facilitate the adoption of the procedure. Eye banks play a crucial role by providing prepared tissues, which would lessen part of the technical difficulty.

Case Report: Idiopathic Subcutaneous Thrombotic Vasculopathy.

Lower extremity ulcers have significant morbidity, with treatment determined by the underlying disorder. Reported is a 32-year-old female presenting with small skin nodules and bruises across her legs 4 weeks following her second COVID vaccination. These lesions progressed into large, necrotic ulcers over several months. Initial work-up showed widespread pannicular thrombotic vasculopathy with ischemic skin necrosis. The tissue was negative for calcification on Von Kossa histochemistry, and a working diagnosis of subcutaneous thrombotic vasculopathy was suggested. The ulcers progressed despite treatments with corticosteroids, therapeutic anticoagulation, intravenous immunoglobulin, plasmapheresis, sodium thiosulfate, wound care, and repeat debridement. Later debridement specimens demonstrated rare vascular and pannicular calcifications. This finding supports the hypothesis that subcutaneous thrombotic vasculopathy is a precursor to calciphylaxis, the patient's current working diagnosis. However, based on the patient's entire clinical picture, a definitive diagnosis has yet to be found. This report highlights the challenges of working with rare diseases and the importance of multidisciplinary cooperation.

Characterization and Antidermatophyte Activity of Henna Extracts: A Promising Therapy for Humans and Animals Dermatophytoses.

Dermatophytoses representing a major global health problem and dermatophyte species with reduced susceptibility to antifungals are increasingly reported. Therefore, we investigated for the first time the antidermatophyte activity and phytochemical properties of the sequential extracts of the Egyptian privet Henna (Lawsonia inermis) leaves. Total phenolic content (TPC), total flavonoids (TF), and antioxidant activity of chloroform, diethyl ether, acetone, ethanol 80%, and aqueous extracts were evaluated. The antifungal activity of henna leaves extracts (HLE) toward 30 clinical dermatophytes isolates, including Trichophyton mentagrophytes, Microsporum canis, and T. rubrum, was determined. Morphological changes in hyphae were investigated using scanning electron microscopy (SEM) analysis. Following the polarity of ethanol and acetone, they exhibited distinct efficiency for the solubility and extraction of polyphenolic polar antioxidants from henna leaves. Fraxetin, lawsone, and luteolin-3-O-glucoside were the major phenolic compounds of henna leaves, as assessed using high-performance liquid chromatography analysis. A high and significant positive correlation was found between TPC, TF, the antioxidants, and the antidermatophyte activities of HLE. Acetone and ethanol extracts exhibited the highest antifungal activity toward the tested dermatophyte species with minimum inhibitory concentration (MIC) ranges 12.5-37.5 and 25-62.5 µg/mL, respectively. Structural changes including collapsing, distortion, inflating, crushing of hyphae with corrugation of walls, and depressions on hyphal surfaces were observed in SEM analysis for dermatophyte species treated with MICs of griseofulvin, acetone, and ethanol extracts. In conclusion, acetone and ethanolic extracts of henna leaves with their major constituent fraxetin exhibited effective antifungal activity toward dermatophyte species and may be developed as an alternative for dermatophytosis treatment. These findings impart a useful insight into the development of an effective and safe antifungal agent for the treatment of superficial fungal infections caused by dermatophytes.

Phase I Trial of Prophylactic Donor-Derived IL-2-Activated NK Cell Infusion after Allogeneic Hematopoietic Stem Cell Transplantation from a Matched Sibling Donor.

Background: NK cell-based immunotherapy to prevent relapse after allogeneic transplantation is an appealing strategy because NK cells can provide strong antitumor effect without inducing graft-versus-host disease (GVHD). Thus, we designed a phase-I clinical trial evaluating the safety of a prophylactic donor-derived ex vivo IL-2 activated NK cell (IL-2 NK) infusion after allo-HSCT for patients with hematologic malignancies. Methods: Donor NK cells were purified and cultured ex vivo with IL-2 before infusion, at three dose levels. To identify the maximum tolerated dose was the main objective. In addition, we performed phenotypical and functional characterization of the NK cell therapy product, and longitudinal immune monitoring of NK cell phenotype in patients. Results: Compared to unstimulated NK cells, IL-2 NK cells expressed higher levels of activating receptors and exhibited increased degranulation and cytokine production in vitro. We treated 16 patients without observing any dose-limiting toxicity. At the last follow up, 11 out of 16 treated patients were alive in complete remission of hematologic malignancies without GVHD features and immunosuppressive treatment. Conclusions: Prophylactic donor-derived IL-2 NK cells after allo-HSCT is safe with low incidence of GVHD. Promising survivals and IL-2 NK cell activated phenotype may support a potential clinical efficacy of this strategy.

Effect of Panax ginseng on Carbamazepine Pharmacokinetics in Rabbits.

OBJECTIVES: Carbamazepine (CBZ) is a well-known drug prescribed to treat epilepsy and the preferred drug for trigeminal neuralgia. This study was conducted to investigate the effect of Panax ginseng extract (PGE) on the disposition of CBZ, a CYP3A4 substrate, in rabbits. MATERIALS AND METHODS: An in vivo randomized parallel design was used to examine herb-drug interactions in 12 male rabbits distributed into 2 groups. In the 1st group (control group), 6 rabbits (control group) were administered orally with CBZ suspension (30 mg/kg/day) as a single daily dose for 10 days. In the 2nd group (test group), 6 rabbits was treated concomitantly with CBZ and a dose of PGE (2.5 mg/kg/day) at the same time as in the 1st group. Blood samples were withdrawn from the marginal ear vein of the rabbits at intervals of 0.0, 0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 4.0, 6.0, 12.0, and 24.0 h. RESULTS: CBZ had no significantly different pharmacokinetic (PK) parameters, namely, Cmax, tmax, AUC0-24, AUC0-∞, t½, and Ke, when it was given alone or concurrently with PGE (p≥0.05). CONCLUSION: PGE may unlikely interfere with the PK of CBZ when it is co-administered with CBZ. Therefore, PGE can be used safely without precautions or dose monitoring.

Outcomes of Corneal Topography among Progressive Keratoconus Patients 12 months following Corneal Collagen Cross-Linking.

PURPOSE: This study aimed to assess the overall and specific topographic changes among patients who underwent corneal collagen cross-linking (CXL) due to progressive keratoconus. METHODS: This retrospective case series study was conducted at a single-arm hospital in King Abdulaziz Medical City, Riyadh. All progressive keratoconus patients who underwent CXL between January 2017 and December 2018 were included consecutively. The epi-off crosslinking technique (Dresden protocol) was applied in all patients. The topographic values were measured preoperatively and 12 months postoperatively. Patients with a history of a previous corneal procedure, corneal trauma, or any corneal scarring were excluded. RESULTS: Among our population (29 eyes of 24 patients), 58.6% of eyes were for male patients, and the mean age of the population was 27.76 ± 4.21 years. Based on the topography results, the mean values of corneal thickness at central 3 mm decreased from 473.45 ± 38 µm to 465.72 ± 41.78 µm following CXL (Z = -1.93, 95% confidence interval [CI] = 0.048-0.057, p= 0.053). Clinically significant astigmatism measurements were present in 28 (96.6%) eyes before CXL compared to 26 (89.7%) eyes after CXL. The mean values of astigmatism among the patients were 3.37 ± 2.25 diopters before and 3.67 ± 2.61 diopters after CXL (Z = -1696, 95% confidence interval [CI] = 0.085-0.096, p = 0.09). After CXL, the mean values of the front elevation at the apex changed from 33.90 ± 20.13 µm to 36.10 ± 21.09 µm (Z = -2.792, 95% [CI] = 0.003-0.006, p = 0.005). The mean values of the back elevation at the apex changed from 68.4 ± 35.66 µm to 69.90 ± 35.89 µm (Z = -0.934, 95% CI = 0.343-0.366, p = 0.35). CONCLUSION: The topographic corneal parameters improved significantly in the patients with corneal ectasia after CXL. These results revealed the safety and efficacy of CXL in stabilizing keratoconus progression among Saudi patients at 1 year of follow-up.

The implication of genetic variation in the complement C3 allotypes on the first-year allograft outcome after live donor liver transplantation.

BACKGROUND: The component (C3) of the complement system constitutes a central element in liver transplantation. C3 is produced mainly by the liver and comprises both slow (C3-S), and fast (C3-F) components. METHODS: The effect of a single nucleotide variation in the C3 gene on the first-year outcome examined by ARMS PCR in 30 recipients of living donor allograft. RESULTS: Frequencies of C3-S and C3-F in the Egyptian recipients' population were 67% and 33%. C3-F allele frequency was prevalent than the C3-S allele in recipients who developed acute rejection. The C3-SF and C3-FF genotypes significantly associated with acute rejection with 6.25 times increase in the risk of rejection than C3-SS (OR: 6.25; CI:1.05-37.07, p < .05). C3-SS increases the survival 2.5 times more than C3-SF or C3-FF but without significant association (OR: 0.40, CI: 0.07-2.44, p = .3). C3 genotypes or allotypes had no significant association with the recipient's survival, death, graft loss, infection, or serum levels of tacrolimus (all p > .05). C3-FF and C3-SF genotypes had the highest HCV recurrence rate but without significant association (p > .05). CONCLUSION: In liver allograft recipients, C3-SF and C3-FF genotypes significantly associated with acute rejection with the C3-F allele more prevalent than the C3-S. C3-SS genotype increases survival without significant association.