A Case Report of Varicella Zoster Virus Infection Progressing to Necrotizing Fasciitis in an Immunocompetent Adult.

Adults who have had varicella zoster virus (VZV) infection may experience the unusual consequence of necrotizing fasciitis (NF), which is brought on by a secondary bacterial infection. The optimum approach to treat this medical condition is with a precise diagnosis, quick antibiotic therapy, and immediate surgery. We present 36-year-old case of post chickenpox NF in an immunocompetent male adult patient by diagnosing clinical and laboratory investigations.

Mycetoma case series in Somalia.

Mycetoma is a suppurative chronic bacterial or fungal disease inoculated into the body by minor trauma which may penetrate from subcutaneous tissue to bone. Although the lower extremities are most commonly affected, rare forms can also be seen from time to time. The diagnostic triad of swelling in the affected area, multiple sinus formation, and purulent discharge with grains are typical. Definitive diagnosis is made by isolation of the causative pathogen, radiologic imaging, and histopathologic examination. Antifungal and antibacterial options are applied together with surgery. Our aim in this case series is to report and analyze 10 rare cases of mycetoma.

Lupus Erythematosus Panniculitis: A Rare Case Report.

An uncommon variation of lupus erythematosus is lupus panniculitis. It can exist on its own or in conjunction with discoid or systemic lupus erythematosus. Persistent, sensitive, and hard nodules that are localized on the face, arms, shoulders, breast, and buttocks are its defining features. Scarring, lipoatrophy, and ulceration are occasionally associated with the healing of lesions. We are reporting the first case of lupus erythematosus panniculitis from Somalia. A 60-year-old male patient visited our polyclinic with an upper back nodule and a left upper ulcerated lesion that had been present for four months.

Poncet's disease: An uncommon presentation of a common disease in Sudan.

Key Clinical Message: Poncet's disease is an acute onset reactive polyarthritis associated with tuberculosis infection. Although uncommon, the diagnosis should be considered among patients presenting with symmetrical polyarthritis in tuberculosis-endemic regions. Abstract: This is a case report of Poncet's disease presenting as bilateral knee and wrist pain associated with swelling. Joint x-rays and immunological assays were normal. A chest x-ray and Gene-Xpert diagnosed tuberculosis. A complete resolution of symptoms was attained following the completion of antituberculous therapy regimen.

Counteract severe heat stress by including different forms of zinc in the rabbit bucks' diet.

The harmful influences of global warming on rabbit reproduction and industry attract global attention. Zinc (Zn) is an important trace element with a wide list of functions in the male reproductive system. The aim of this study was to estimate the effects of different forms of zinc supplementation, as organic (Zn methionine), nano (nano Zn oxide) as indirect way to minimized it impact on environment, and inorganic (Zn sulphate) on physiological parameters, semen quality, anti-oxidative status, hormonal profiles of male rabbits subjected to server heat stress. Thirty-six V-line bucks (6-7 months old, 2842.29 ± 34.46 g weight) were randomly distributed to 4 groups, bucks in 1st group (control group, Con) fed basal diet without Zn supplementation, the 2nd, 3rd and 4th groups fed basial diet with 30 mg/kg of zinc methionine (Zn-Met), nano zinc oxide (ZnO-NPs), and zinc sulphate (Zn-S), respectively for a period of 10 weeks suffered from severe heat stress of environmental ambient temperature (over 32 of temperature humidity index, THI). Semen samples were collected and evaluated for volume, pH, motility, concentration, viability, initial fructose, and seminal plasma antioxidant concentration. Liver, kidney function, hormonal and antioxidant profile were measured in blood serum. The results revealed that, compared to control, all forms of Zn supplementation used significantly improved kidney function (creatinine), serum antioxidant (SOD and CAT), physiological parameters, especially on 1st month of the experiment, and seminal plasma antioxidant (SOD and CAT) of heat stressed bucks. Likewise, semen quality in terms of sperm concentration, sperm viability, and initial fructose enhanced significantly (P ≤ 0.05) by ZnO-NPs supplementation. Zinc methionine supplementation significantly improved liver function and decreased seminal plasma TBARs. Treatments with Zn-Met and ZnO-NPs increased seminal TAC and blood testosterone levels with reduced blood cortisol levels compared to other groups. Severe heat stress could be counteract by inclusion Zn with studied forms Zn-Met and ZnO-NPs at recommended dose (30 mg/kg diet) to improve semen quality and antioxidant status.

Biogenic silver nanoparticles eradicate of Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus (MRSA) isolated from the sputum of COVID-19 patients.

In recent investigations, secondary bacterial infections were found to be strongly related to mortality in COVID-19 patients. In addition, Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus (MRSA) bacteria played an important role in the series of bacterial infections that accompany infection in COVID-19. The objective of the present study was to investigate the ability of biosynthesized silver nanoparticles from strawberries (Fragaria ananassa L.) leaf extract without a chemical catalyst to inhibit Gram-negative P. aeruginosa and Gram-positive Staph aureus isolated from COVID-19 patient's sputum. A wide range of measurements was performed on the synthesized AgNPs, including UV-vis, SEM, TEM, EDX, DLS, ζ -potential, XRD, and FTIR. UV-Visible spectral showed the absorbance at the wavelength 398 nm with an increase in the color intensity of the mixture after 8 h passed at the time of preparation confirming the high stability of the FA-AgNPs in the dark at room temperature. SEM and TEM measurements confirmed AgNPs with size ranges of ∼40-∼50 nm, whereas the DLS study confirmed their average hydrodynamic size as ∼53 nm. Furthermore, Ag NPs. EDX analysis showed the presence of the following elements: oxygen (40.46%), and silver (59.54%). Biosynthesized FA-AgNPs (ζ = -17.5 ± 3.1 mV) showed concentration-dependent antimicrobial activity for 48 h in both pathogenic strains. MTT tests showed concentration-dependent and line-specific effects of FA-AgNPs on cancer MCF-7 and normal liver WRL-68 cell cultures. According to the results, synthetic FA-AgNPs obtained through an environmentally friendly biological process are inexpensive and may inhibit the growth of bacteria isolated from COVID-19 patients.

Total hip arthroplasty for post-firearm hip arthritis complicated by coloarticular fistula: A case report.

Hip firearm injuries are rare injuries that could lead to serious complications, such as posttraumatic hip arthritis and coloarticular fistula. We report a case of a 25-year-old male who sustained a pelvic injury caused by a single bullet which led to a bilateral acetabular fracture, concomitant with a colon injury treated on an emergency basis by a diverting colostomy; acetabular fractures were treated conservatively by traction. After the patient recovered from the abdominal injury, he was presented with bilateral hip pain and limited motion; plain radiographs showed bilateral hip arthritis with proximal migration of the femoral head and bilateral acetabular defect classified as Paprosky type ⅢA. Reconstruction of the hips was performed using the same technique: impaction bone grafting for acetabular defect reconstruction and a reversed hybrid total hip arthroplasty (THA) 6 months apart. The patient presented with loosening of the left THA acetabular cup 3 years later, which was revised; then he presented with a discharging sinus from the left THA with suspicion of coloarticular fistula, which was confirmed using CT with contrast material. A temporary colostomy and fistula excision were performed, and a cement spacer was applied to the hip. After clearing the infection, a final revision THA for the left hip was performed. Treating post-firearm hip arthritis by THA is challenging, especially in the situation of neglected cases with the presence of an acetabular defect. Concomitant intestinal injury increases the risk of infection with the possibility of coloarticular fistula formation, which could present later. Working with a multidisciplinary team is paramount.

Evaluation of Microvascular and Visual Acuity Changes in Patients with Early Diabetic Retinopathy: Optical Coherence Tomography Angiography Study.

PURPOSE: Comparison of early microvascular changes detected by optical coherence tomography angiography (OCTA) in patients with mild non-proliferative diabetic retinopathy (NPDR) with healthy volunteers. PATIENTS AND METHODS: Forty-four eyes of 44 type-2 diabetic patients with mild non-proliferative diabetic retinopathy and 30 eyes of 30 age-matched healthy controls were imaged using OCTA to quantify microvascular changes and the FAZ quantitative parameters (area, perimeter, and circularity index); the values of patients and controls were then compared. RESULTS: Macular vessel density, perfusion index, and circularity index values were reduced and positively correlated with visual acuity in patients (15.4 ± 2.6, 38.0 ± 6.7, 0.6 ± 0.06 and p = 0.003, 0.001, and 0.003, respectively). However, FAZ area and perimeter were found to be larger in patients than controls (0.30 ± 0.08, 2.5 ± 0.3 and p < 0.001). CONCLUSION: OCTA quantified vessel density and perfusion density were found to be correlated with visual acuity and FAZ parameters in patients with early NPDR; this could help in detecting early disease progression and modifying treatment decisions.

Extracellular biosynthesis of silver nanoparticles using Rhizopus stolonifer.

Synthesis of silver nanoparticles (AgNPs) has become a necessary field of applied science. Biological method for synthesis of AgNPs by Rhizopus stolonifer aqueous mycelial extract was used. The AgNPs were identified by UV-visible spectrometry, X-ray diffraction (XRD), transmission electron microscopy (TEM) and Fourier transform infrared spectrometry (FT-IR). The presence of surface plasmon band around 420 nm indicates AgNPs formation. The characteristic of the AgNPs within the face-centered cubic (fcc) structure are indicated by the peaks of the X-ray diffraction (XRD) pattern corresponding to (1 1 1), (2 0 0) and (2 2 0) planes. Spherical, mono-dispersed and stable AgNPs with diameter around 9.47 nm were prepared and affirmed by high-resolution transmission electron microscopy (HR-TEM). Fourier Transform Infrared (FTIR) shows peaks at 1426 and 1684 cm-1 that affirm the presence of coat covering protein the AgNPs which is known as capping proteins. Parameter optimization showed the smallest size of AgNPs (2.86 ± 0.3 nm) was obtained with 10-2 M AgNO3 at 40 °C. The present study provides the proof that the molecules within aqueous mycelial extract of R. stolonifer facilitate synthesis of AgNPs and highlight on value-added from R. stolonifer for cost effectiveness. Also, eco-friendly medical and nanotechnology-based industries could also be provided. Size of prepared AgNPs could be controlled by temperature and AgNO3 concentration. Further studies are required to study effect of more parameters on size and morphology of AgNPs as this will help in the control of large scale production of biogenic AgNPs.

Clinical and Laboratory Profile of Urinary Tract Infections Associated with Extended Spectrum ß-Lactamase Producing Escherichia coli and Klebsiella pneumoniae.

BACKGROUND: Urinary tract infection (UTI) is mainly due to invasion of the urethra, bladder or kidneys by pathogens. The emergence of extended spectrum ß-lactamases (ESBL) is responsible for frequently observed empirical therapy failures. OBJECTIVES: To study the clinical and laboratory characteristics of UTIs caused by ESBL producing Escherichia coli (E. coli) and Klebsiella pneumonia (K. pneumonia). METHODS: A cross-sectional clinical and laboratory study was performed at King Khalid Hospital, Hafr Al Batin, Saudi Arabia between March 2014 to October 2015. A total of 908 urine samples from suspected UTI patients was collected. Samples were isolated on Cysteine Electrolyte-Deficient (CLED) agar. Positive cultures were identified and tested for antimicrobial susceptibility by MicroScan(®) WalkAway-96 SI System, and then ESBL was confirmed by double disc synergy test (DDST) and phenotypic confirmatory disc diffusion test (PCDDT). RESULTS: A total of 680 samples (288 males and 392 females) were culture positive. 520 samples (76.5%) of E. Coli were found and 160 samples of K. pneumonia were identified (23.5%). ESBL testing showed 296 (218 E. coli and 78 K. pneumonia) samples of positive isolates. Non-ESBL isolates showed highest resistance to ampicillin followed by Mezocillin and Trimethoprim-Sulphamethoxazole-which are usually recommended as the initial treatment of UTI-while ESBL isolates showed resistance to third generation cephalosporin along with Ampicillin and Trimethoprim-Sulphamethoxazole. In this study, four significant risk factors for ESBL infection such as diabetes, recurrent UTI, previous use of antibiotics and previous hospitalization were found. CONCLUSION: Identifying the risk factors and antibiotic susceptibility patterns associated with ESBL producing E. coli and K. pneumonia is a useful guide for treatment strategy and control of ESBL UTI.

RAPD analysis and antibiotic susceptibility for Mycobacterium tuberculosis strains isolated from different locations in Egypt

The routine identification of mycobacterial strains isolated from patients in different locations in Egypt was confirmed by specific DNA fragment amplification. The susceptibilities of 72 Mycobacterium tuberculosis strains against the four antibiotics used in tuberculosis treatment (Isoniazid, INH; Rifampicin, Rif; Streptomycin, St and Ethambutol, E) were examined. Our results indicated that, multi drug resistant tuberculosis (MDR-TB) represents about 19.5% of the tested strains, whereas sensitive strains represented 26.4%. The genetic polymorphism of the tested strains was examined using RAPD analysis. Six selected strains represent the different antibiotic susceptibility groups were examined using RAPD fingerprinting. No difference between the strains was recorded using the RFLP analysis of amplified specific fragment. The discrimination power of RAPD analysis was inadequate to clarify the genetic correlation between the tested strains. MDR-TB was approximately double time in 2008 compared with the value in 2007. Most of the new MDR-TB was correlated with resident dense population regions.