[Succès de traitement par Cabergoline d'une série de cas de cardiomyopathie du péripartum, incluant un cas critique nécessitant une assistance circulatoire mécanique]. / Successful treatment with Cabergoline in critical peripartum cardiomyopathy patient on Veno-Arterial Extra Corporeal Membrane Oxygenation.

Peripartum cardiomyopathy is a life-threatening condition that requires urgent diagnosis and management. Bromocriptine was established as disease specific therapy; less data is known about Cabergolin which is another prolactin secretion inhibitor. In this paper we report 4 peripartum cardiomyopathy cases treated successfully with Cabergoline, including a cardiogenic shock case requiring mechanical circulatory support.

Epidemiological Characteristics, Pathogenesis and Clinical Implications of Sinusitis in the Era of COVID-19: A Narrative Review.

Sinusitis is a common condition with various forms and different etiologies. In the era of COVID-19, a large number of studies covered the association between sinusitis and COVID-19, while others reported the impact of COVID-19 on the development of acute invasive fungal rhinosinusitis (AIFR), together with the most commonly associated predisposing factors. Fungal sinusitis, particularly AIFR, can be life-threatening. It is important to dissect this association and improve current evidence and management. Therefore, we conducted this literature review to highlight the association between COVID-19 and sinusitis based on evidence from the available studies in the literature. Evidence shows that chronic sinusitis might have a negative impact on COVID-19 outcomes. However, current results are conflicting, and further studies are needed. On the other hand, COVID-19 can also cause olfactory dysfunction, which is usually temporary. In addition, we found several studies that indicated the association between COVID-19 and AIFR. The condition is usually associated with severe morbidities, as affected patients are usually immunocompromised, including those with uncontrolled diabetes, malignancy, immunosuppression, AIDS, the administration of chemotherapy and other immunosuppressive drugs, and COVID-19.

Retrospective prevalence and associated risk factors of Mycoplasma haemofelis infection in owned cats.

Data on the prevalence and associated risk factors of naturally occurring haemoplasmosis in owned cats in Malaysia is limited. Being the most pathogenic of the three known feline haemoplasma species, Mycoplasma haemofelis (Mhf) infection was analysed from 2016 to 2019 to determine the periodical prevalence and associated risk factors in Northeastern Malaysia - Kelantan. Archived patient data of 77 clinically ill cats suspected of having M. haemofelis infection were reviewed in this study. Out of the 77 suspected cases, 53 (68.8%) were clinically diagnosed with haemoplasmosis amongst which 46 (59.7%) of the subpopulation were further confirmed with polymerase chain reaction (PCR). Risk factors for M. haemofelis infection (age, breed, ectoparasitism, household condition, roaming status, and sex) were analysed. There was no significant association of breed, ectoparasitism, household condition (number of cats) and occurrence of clinical signs with feline mycoplasmosis. Young, male and roamer cats were more likely to be diagnosed of mycoplasmosis than other categories of cats in this study. There was also a significant association between cats infected with 'Candidatus Mycoplasma haemominutum' with M. haemofelis. Thus, the coinfection of these two haemoplasma species is not uncommon. This study indicates that infection by M. haemofelis in anaemic cats is a common find in client-owned cats from Northeastern Malaysia. As the natural mode of transmission of haemoplasma infection remain unestablished, information in this study may highlight the importance of this disease and contribute to effective prevention and control strategies to minimize feline infectious anaemia (FIA) caused by M. haemofelis.

Detection of colistin-resistant Escherichia coli isolated from broiler chickens in Kelantan, Malaysia.

Antimicrobial resistant Escherichia coli have become an ever increasing problem in human, and animal health and production. The imprudent use of antibiotics and poor hygienic practices especially in poultry industries have been contributing to the emergence and spread of E. coli species resistant to broad spectrum antibiotics including Colistin. This study was conducted to detect colistin - resistance and antibiotic sensitivity patterns in E. coli isolated from broiler chickens in Kelantan. A total of 320 cloacal swabs were collected from apparently healthy broiler chickens in different districts of Kelantan and were analysed using routine microbiological methods, Kirby-Bauer method for antimicrobial susceptibility test and PCR amplification of species-specific and colistin - resistance encoding genes. Out of the 320 samples, 91 isolates were confirmed as E. coli and 21/91 (23.08%) were positive for colistin - resistant encoding gene, mcr-1. Most of the isolates were resistant to tetracycline (95.24%), chloramphenicol (85.71%), and sulphamethoxazole/ trimethoprim (85.71%). However, the isolates were less resistant towards piperacillin/ tazobactam (4.76%) and meropenem (9.52%). The findings from this study reveal the emerging threats of colistin - resistant in local food animal production, particularly in poultry production industry. However, more comprehensive, and large-scale studies focusing on more resistance patterns using determination of minimum inhibitory concentration (MIC), virulence and resistance characteristics and molecular epidemiology of colistin - resistant E. coli are recommended for better understanding of the epidemiology and to implement the appropriate control and prevention strategies.

Detection of pathogenic Vibrio species and antibiogram activity in Asian Seabass (Lates calcarifer) in Tumpat, Kelantan.

Some of Vibrio species is well known as pathogenic bacteria in aquaculture and the marine industry. Its infection is able to generate a massive outbreak and affect the fish population, especially for net caged fish such as seabass. This study was conducted to investigate the prevalence of Vibrio spp. isolated from seabass (Lates calcarifer) in Sri Tujuh Lagoon, Tumpat, Kelantan. Then, to determine the antibiotic resistance in Vibrio isolates. Polymerase chain reaction (PCR) was used to detect Vibrio species using specific primer VR169 and VR744 with estimation base pair size band, 597 bp and further identified by sequencing. On the other hand, antibiotic susceptibility tests were continued by using 13 types of antibiotics; kanamycin (K30), chloramphenicol (C30), neomycin (N10), ampicillin (AMP10), nitrofurantoin (F300), tetracycline (TE30), streptomycin (S10), norfloxacin (NOR10), ciprofloxacin (CIP5), nalidixic acid (NA30), gentamicin (CN10), doxycycline (DO30) and sulfamethoxazole (SXT100). As a result, 14 Vibrio isolates were identified, including Vibrio fluvialis (n=6), Vibrio parahaemolyticus (n=3), Vibrio harveyi (n=2) and each isolate for Vibrio vulnificus, Vibrio alginolyticus and Vibrio spp. The results showed that all isolates were sensitive to most antibiotics except ampicillin, neomycin and streptomycin. The MAR index value was ranging from 0 to 0.31. This study demonstrates the prevalence of Vibrio spp. in seabass and the report on multidrug resistance strains that could be of concern to the fish farmers. In addition, data from this study can be further used in fish disease management plans.

Detection of pathogenic Vibrio species and antibiogram activity in Asian Seabass (Lates calcarifer) in Tumpat, Kelantan

@#Some of Vibrio species is well known as pathogenic bacteria in aquaculture and the marine industry. Its infection is able to generate a massive outbreak and affect the fish population, especially for net caged fish such as seabass. This study was conducted to investigate the prevalence of Vibrio spp. isolated from seabass (Lates calcarifer) in Sri Tujuh Lagoon, Tumpat, Kelantan. Then, to determine the antibiotic resistance in Vibrio isolates. Polymerase chain reaction (PCR) was used to detect Vibrio species using specific primer VR169 and VR744 with estimation base pair size band, 597 bp and further identified by sequencing. On the other hand, antibiotic susceptibility tests were continued by using 13 types of antibiotics; kanamycin (K30), chloramphenicol (C30), neomycin (N10), ampicillin (AMP10), nitrofurantoin (F300), tetracycline (TE30), streptomycin (S10), norfloxacin (NOR10), ciprofloxacin (CIP5), nalidixic acid (NA30), gentamicin (CN10), doxycycline (DO30) and sulfamethoxazole (SXT100). As a result, 14 Vibrio isolates were identified, including Vibrio fluvialis (n=6), Vibrio parahaemolyticus (n=3), Vibrio harveyi (n=2) and each isolate for Vibrio vulnificus, Vibrio alginolyticus and Vibrio spp. The results showed that all isolates were sensitive to most antibiotics except ampicillin, neomycin and streptomycin. The MAR index value was ranging from 0 to 0.31. This study demonstrates the prevalence of Vibrio spp. in seabass and the report on multidrug resistance strains that could be of concern to the fish farmers. In addition, data from this study can be further used in fish disease management plans.

Knowledge attitude and practice of safety measures for corona virus disease - 19 (COVID-19) among general population.

OBJECTIVE: To evaluate the knowledge, attitude, and practice of general population for Corona virus disease 19 (COVID-19). METHODS: A total of 950 participants submitted an online self-administered questionnaire, which was developed through literature search and validated. The online survey link was distributed through various social media platforms (WhatsApp, Instagram, Facebook, LinkedIn, Twitter, Snapchat, Pinterest, and Tumblr). And 861 forms were included in the study after checking for completion of relevant response from participants, whereas 89 forms were excluded. The data were analyzed through Statistical Package for Social Sciences. Descriptive statistics were performed for percentage and frequency determination of quantitative and qualitative variables. Spearman's correlation and Chi square test were performed to control confounders and association of knowledge, attitude, and practices with gender and education level. The P value <0.05 was considered as statistically significant. RESULTS: More than two third of the population was aware of COVID-19 and three fourth had had bachelor's degrees, whereas 18% had master level education. 85% have not attended any courses, awareness campaigns, and lectures to inculcate recent and updated knowledge. 83% believed that COVID-19 is a serious threat to the community; hence, prevention strategies should be adopted. There was no significant relationship (p = 0.23) between knowledge, attitude, and practice levels with gender, whereas a significant relationship (p = 0.01) was noted with education of participant. Similarly, a significant relationship (p = 0.00) was seen between knowledge and practices of participants toward COVID-19. CONCLUSION: The studied population displayed adequate knowledge, attitude, and practice to combat COVID-19. However, we also find a knowledge gap between information source and perception of COVID-19 among our study participants. Therefore, there is a critical need for effective education and widespread public campaigns aiming to enhance relevant and contemporary information related to prevention and management of COVID-19.

The Lebanese left ventricular assist device experience, a success story despite the odds.

BACKGROUND AND AIM: Heart failure is still a leading cause of mortality and morbidity. Assist devices are reserved for advanced heart failure patients with no other therapeutic options. We aim in this paper to describe the characteristics and outcome of Lebanese left ventricular assist device (LVAD) patients. RESULTS: From 2010 till December 2019, 78 patients were implanted with assist devices at the Beirut cardiac Institute, 82 pumps were used. To the most recent follow up after 10 years, 26 patients died (34%). 24 patients of 35 (68%) survived more than 5 years. Seven patients only (9%) died during one month of surgery. One year mortality was 19% (15 patients). The leading cause of early mortality was infection, whereas cerebrovascular accidents CVA were the leading cause of late mortality. Pump thrombosis occurred in 12% of the cases. The most serious long term complication was haemorrhagic CVA. Only seven patients (9%) received heart transplantation, with a mean time on support prior to transplantation of 1303 ± 213 days. CONCLUSION: In this manuscript we reported the characteristics and outcome of the largest population of LVAD patients in Lebanon. The survival rate was 81% at one year. These findings were comparable to the international registries except for rates of heart transplantation. More efforts should be made to encourage organ donation in Lebanon.

Right ventricle failure in patients treated with left ventricular assist device.

This review article aim to highlight the right ventricular function peri left ventricular assist device implantation, and to assess the incidence, physiopathology, predictors, management and prognosis, of right ventricular failure post-implant.

Unified interatomic potential and energy barrier distributions for amorphous oxides.

Amorphous tantala, titania, and hafnia are important oxides for biomedical implants, optics, and gate insulators. Understanding the effects of oxide doping is crucial to optimize performance in these applications. However, no molecular dynamics potentials have been created to date that combine these and other oxides that would allow computational analyses of doping-dependent structural and mechanical properties. We report a novel set of computationally efficient, two-body potentials modeling van der Waals and covalent interactions that reproduce the structural and elastic properties of both pure and doped amorphous oxides. In addition, we demonstrate that the potential accurately produces energy barrier distributions for pure and doped samples. The distributions can be directly compared to experiment and used to calculate physical quantities such as internal friction to understand how doping affects material properties. Future analyses using these potentials will be of great value to determine optimal doping concentrations and material combinations for myriad material science applications.

[Severe and moderate haemophilia under prophylactic replacement treatment--maximal knee extensor and flexor torque of children and adolescents]. / Schwere und mittelschwere Hämophilie unter prophylaktischer Substitutionstherapie. Maximale Drehmomente der Knieextensoren und Knieflexoren bei Kindern und Jugendlichen.

UNLABELLED: Due to its influence on haemophilic arthropathy, the evaluation of knee extensor (K(Ext)) and flexor (K(Flex)) torques plays an important role in the preventive and rehabilitative context of haemophilia. Thus, the present study aimed at investigating maximal static torque (M(Max)) of K(Ext) and K(Flex). 14 boys with haemophilia (8 severe, 6 moderate; age: 11.7 ± 2.8 years; prophylactic treatment > 5 years) and 14 healthy carefully pair-matched controls (age: 11.5 ± 2.7 years) were separately measured for the left and right leg for M(Max). Furthermore, the ratio K(Flex)/K(Ext )was calculated and the joint situation assessed using the Haemophilia Joint Health Score. RESULTS: No significant group-effect was observed for M(Max) of the K(Ext) and K(Flex) as well as for the ratio K(Flex)/K(Ext) (p>0.05). Despite significant higher joint scores in haemophilic children compared to their healthy controls (p<0.01), patients merely showed minor joint impairments. CONCLUSION: Children and adolescents with severe and moderate haemophilia under prophylactic replacement treatment with a good joint status showed comparable maximal strength performance of relevant knee muscles compared to their healthy peers.

The effect of aerated rock filter geometry on the rate of nitrogen removal from facultative pond effluents.

Rock filters are an established technology for polishing waste stabilization pond effluents. However, they rapidly become anoxic and consequently do not remove ammonium-nitrogen. Horizontal-flow aerated rock filters (HFARF), developed to permit nitrification and hence ammonium-N removal, were compared with a novel vertical-flow aerated rock filter (VFARF). There were no differences in the removals of BOD5, TSS and TKN, but the VFARF consistently produced effluents with lower ammonium-N concentrations (<0.3 mg N/L) than the HFARF (0.8-1.5 mg N/L) and higher nitrate-N concentrations (24-29 mg N/L vs. 17-24 mg N/L).

[Cerebral aneurysm and subarachnoid hemorrhage revealed by a Tako Tsubo syndrome]. / Syndrome de Tako Tsubo révélant une hémorragie méningée par rupture d'anévrisme.

Cerebral hemorrhage is usually associated to many cardiac disorders, mimicking acute coronary syndrome. We relate a case of a postmenopausal woman presenting at emergency room for acute coronary syndrome and whose evaluation revealed a subarachnoidal hemorrhage, normal coronary arteries, and a typical Tako Tsubo aspect on echocardiography with apical ballooning and hyperkinesis with basal hypokinesis.

[Heart rate variability alteration in patients on chronic hemodialysis]. / Altération de la variabilité sinusale chez les malades en hémodialyse chronique.

BACKGROUND AND AIM: Decrease in heart rate variability (HRV) is a known risk factor for cardiovascular morbidity and mortality. The aim of our study is to evaluate HRV in chronic hemodialysis patients and to determine factors that might decrease or increase it. METHODS: This is a retrospective study including 51 patients, 23 males and 28 females, with a mean of age of 64.5 years (23-84 years) on chronic hemodialysis for end stage renal disease due to various causes. Twenty-four-hour heart rate monitoring was recorded in all patients to evaluate HRV. HRV of hemodialysis patients was compared to normal patients (control). We also looked for correlation between HRV and a number of clinical and biological factors. RESULTS: All HRV parameters were decreased in chronic hemodialysis patients compared to normal controls with a significant difference (p<0.0005). HRV decreases with age (p=0.012), and is lower in diabetic patients (p=0.026). Interestingly, we found that chronic hemodialysis patients on beta-blockers had higher HRV with p=0.011. CONCLUSION: HRV is reduced in chronic hemodialysis patients mainly in old and diabetic patients, but this decrease is less important in those receiving beta-blockers.

[Beneficial effect of sildenafil following surgery for mitral stenosis complicated by pre-capillary pulmonary hypertension: report of two cases]. / Effet bénéfique du sildénafil en postopératoire dans le rétrécissement mitral compliqué d'hypertension artérielle pulmonaire précapillaire: a propos de deux cas.

Pulmonary hypertension is a serious disorder, difficult to treat especially in the severe forms. The treatment consists mainly of calcium channel blockers, anti-coagulation, intravenous epoprostenol, inhaled nitric oxide and recent agents as bosentan and sildenafil. Sildenafil, a phosphodiesterase 5 specific inhibitor, has been largely evaluated in primary pulmonary hypertension, and in some cases of secondary pulmonary hypertension including parenchymal and thromboembolic diseases; it has not yet been evaluated in severe pulmonary hypertension with elevated pre-capillary resistance in operated mitral stenosis. We report the cases of two patients operated from mitral valve replacement for severe mitral stenosis with elevated pre-capillary resistance, where oral sildenafil, introduced empirically immediately after the surgical procedure at the dose of 50 mg/d, permitted a significant decrease in pulmonary pressures and resistances, allowing a rapid withdrawal of nitric oxide and reducing therefore hospitalization time in the intensive care unit. We think that this simple treatment, with or without association to nitric oxide, should be generalized to persistent pulmonary hypertension following cardiac surgery.