Flow control by circular cavities in lateral flow porous membranes.

This research explores the flow penetration in porous media by virtue of capillary action and geometric control of the liquid imbibition rate in microfluidic paper-based analytical devices (µPADs) having applications in food quality management, medical diagnostics, and environmental monitoring. We examine changes in flow resistance and membrane geometry, aiming to understand factors influencing capillary penetration rates for various practical applications. We conducted experiments and simulations using lateral porous membranes and altered the flow resistance by changing the liquids or the paper channel geometry by adding cavities. From experiments, it was revealed that by creating a circular cavity in the paper channel, the penetration rate was sufficiently altered. Moreover, increasing the cavity size and type of liquid (w.r.t. viscosity) also caused a decrease in the flow rate. Imbibition rates were also influenced by the position of the cavities in the paper channel. The maximum delay for water was almost 2 times with a 16 mm circular cavity located at 3 cm from strip bottom edge. Overall, we attained a maximum delay in the case of castor oil which was almost 85 times slower than water and 3.7 times slower than olive oil. A good agreement was observed with CFD analysis. We believe that this research would help in developing advance techniques to enhance the flow control strategies in µPADs and indicators.

Bronchial Asthma With Scimitar Syndrome: A Case Report.

Scimitar syndrome is a rare congenital cardiopulmonary anomaly; it is also called venolobar syndrome, hypogenic lung syndrome, and Halasz syndrome. The syndrome is characterized by cardiac dextroposition, right lung and pulmonary artery hypoplasia as well as complete or partial anomalous pulmonary venous drainage of the right lung. We report a case of a 22-month-old full-term male child with a severe form of scimitar syndrome diagnosed at birth. The X-ray demonstrated dextrocardia and right lung hypoplasia, while the echocardiography clearly illustrated the scimitar vein. The patient had multiple ER visits and hospitalizations due to asthma exacerbation that was aggravated by recurrent respiratory tract infections; he responded well to asthma medications during his admissions yet compliance to his prophylactic asthma medications was poor at home.

Do implied volatilities of stock and commodity markets affect conventional & shariah indices differently? An evidence by OVX, GVZ and VIX.

The current study aims to investigate how index returns of conventional and shariah indices of the USA, Europe, and Asia are affected by changes in oil prices, gold prices, VIX, gold-VIX, and oil-VIX. In our investigation, we used the S&P 500, S&P Europe 350, S&P Pan Asia, and their relevant shariah counterparts for the USA, Europe, and Asia. To examine how the explanatory factors affect the overall distribution of the explained variables, we used OLS and quantile regression. For the time frame prior to Covid-19, we discover that all volatility indices-OVX, GVZ, and VIX-influence returns of all indices simultaneously, and that all variables-aside from the spot price of oil-have a greater impact during the bear phase according to QR findings. Further, Volatility indices have a greater impact on volatility of index returns during the Covid-19 period. This is largely because the Covid-19 outbreak had a rapid impact on economies all around the world, and the only thing that affected financial markets consistently was high volatility. This is further supported by the findings of BEKK, which demonstrate that volatility extends across all markets and originates from commodities like gold, oil, gold-VIX, and VIX. Evidence for this can be seen in the fact that during the COVID-19 period, stock prices reacted more favorably to oil price volatility than to oil spot prices, which even went negative on April 20, 2020. Because of this, market stability can be promoted by reducing volatility through the prompt dissemination of crucial information, even while governments have little direct control over the prices of significant commodities like gold and crude oil.

Impact of restructuring an inpatient pediatric service on length of stay and patient flow.

OBJECTIVES: To determine the impact of implementing a new pediatric inpatient structure - the clinical teaching unit (CTU) - on length of stay (LOS) and other patient care outcomes. METHODS: A retrospective study was carried out on children admitted to the General Pediatric Inpatient Service at King Abdullah Specialized Children's Hospital, Riyadh, Saudi Arabia, between July 2015 and December 2018. The main outcome measures were median and mean LOS before and after CTU implementation. Other outcomes measured were the proportion of patients discharged on weekends, during daytime, and within 24 hours of admission, and the proportion of patients readmitted within 7 days of discharge. RESULTS: Median LOS decreased from 2.80 to 2.63 days after CTU implementation (p<0.0001). The proportion of weekend discharges significantly increased after CTU implementation from 18% to 21.5% (p<0.0243) and daytime discharges significantly increased from 6.9% to 25.6% (p<0.0001) after CTU implementation. The improvements in LOS were sustained in the years after CTU implementation, with median LOS decreasing from 2.71 to 2.60 days during 2016-2018 (p<0.001) and mean LOS decreasing from 5.03 to 3.92 days (p=0.0031). During the same period, readmission rates remained stable at 3.5-4%. CONCLUSION: The implementation of a new pediatric inpatient team structure led to significant improvements in many patient care outcomes, including decreased LOS.

Internet of Things enables smart solid waste bin management system for a sustainable environment.

Solid waste management (SWM) is a pressing concern and significant research topic that requires attention from citizens and government stakeholders. Most of the responsibility of waste management is on the municipal sector for its collection, reallocation, and reuse of other resources. The daily solid waste production is more than 54,850 tonnes in urban areas and is difficult to manage due to limited resources and different administrative and service issues. New technologies are playing their role in this area but how to integrate the technologies is still a question, especially for developing countries. This paper is divided into two main phases including a detailed investigation and a technological solution. In the first phase, the data is collected by using the qualitative method to investigate and identify the issues related to waste management. After a detailed investigation and results, the gap is identified by using statistical analysis and proposed a technological solution in the second phase. The technology-based solution is used to control and manage waste with a low-cost, fast, and manageable solution. The new sensor-based technologies, cellular networks, and social media are utilized to monitor the trash in the areas. The trash management department receives notification via cellular services to locate the dustbin when the dustbin reaches a maximum level so the department may send a waste collector vehicle to the relevant spot to collect waste. The smart and fast solution will connect all stakeholders in the community and reduce the cost and time and make the collection process faster. The experiment results indicated the issues and effectiveness of the proposed solution.

Implications of Early Diagnosis and Intervention in the Management of Neurodevelopmental Delay (NDD) in Children: A Systematic Review and Meta-Analysis.

Neuro-developmental delay (NDD) is when a child's reflexes and nervous system are underdeveloped or immature at a given stage of child development. Neurodevelopmental delays account for delayed skill development surrounding speech, social, emotional, behavioral, motor, and cognitive delays. NDD might affect the child's psychological and physical well-being, resulting in chronic disease and disabilities throughout adulthood. This review sought to investigate the implication of early diagnosis and intervention of NDD in children. In this regard, this research opted for a systematic meta-analysis that used keywords and Boolean operators to search through main databases, including the Web of Science, JStor, PsychINFO, Science Direct, Cochrane, Scopus, and ASSIA. The result identified that telehealth interventions improved the management of NDD in children. Also, the Early Start Denver Model (ESDM) model was determined to improve the quality of life for NDD children. Another model was LEAP (Learning Experience and Alternative Program for Preschoolers and Their Parents) and Leap (Learning, engaging, and Playing), which improved behavioral, education, and social interventions in NDD children. The study identified that technology could revolutionize NDD interventions in children, possibly improving the quality of life. The parent-children relationship was shown to enhance the management of this condition; thus, it is recommended as one of the best ways to intervene in the management of NDD. Most importantly, the integration of machine learning algorithms and technology can create models; while this may not be significant in the treatment of childhood NDD but instead might be ideal in improving the quality of life for NDD children. Moreover, their social and communication skills along with academic achievements will improve. The study proposes further research in order to understand the different types of NDDs and their intervention strategies to help the researchers identify the most accurate models to improve the conditions and support the parents and guardians in the management.

The Prevalence and Incidence of Hemolytic Uremic Syndrome: A Systematic Review.

A hemolytic uremic syndrome is an uncommon but severe condition brought on by an overactive alternative complement system, typically involving a hereditary component. It will be crucial to comprehend the epidemiology of hemolytic uremic syndrome as research advances toward bettering its diagnosis and treatment. A systematic review was conducted to evaluate the incidence and prevalence estimates of hemolytic uremic syndrome (HUS) internationally. A thorough literature search was conducted using PubMed, Springer, Cochrane Library for Systematic Reviews, and Embase databases between 2012 and 2023 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 recommendations. A further source of data was the PubMed Central search engine. To make sure that the evaluation included just the studies that were the most pertinent, a population, interventions, comparators, and outcomes (PICO) eligibility criterion was also used. Eight articles were included in this review. HUS had an annual crude incidence of 0.66 per 100,000 people and a standard annual incidence of 0.57 per 100,000 people. Females were more likely than males to develop HUS, but only marginally more frequently. Patients under 20 years old were the age group where HUS was most common. HUS had an average cost of $21,500 per patient, which was more expensive than the country's overall inpatient average cost for the same period. This is due to patients requiring supportive care, antibiotics, plasma exchange, plasma infusion, and renal replacement therapy, and it could take multiple courses of treatment before they improve. It was concluded that several variables, including the region, the age group affected, and the frequency of the underlying bacterial infection, determine the prevalence and incidence of HUS. HUS is often more common in children than adults and is more common in some nations. Overall, HUS is an uncommon disorder that can have significant repercussions for people who have it. For better results and fewer consequences, HUS must be diagnosed and treated as soon as possible.

Blood Transfusion Vs. Hydroxyurea for Stroke Prevention in Children With Sickle Cell Anemia: A Systematic Review and Meta-Analysis.

Sickle cell anemia (SCA) is a hereditary condition that can lead to severe complications in children such as acute coronary syndrome, splenic sequestration, renal failure, and stroke. Blood transfusion and hydroxyurea (HU) therapy are used to prevent stroke in children with sickle cell disease (SCD). Preliminary data show considerable variation and inconsistency in the use of these two therapeutic interventions. Therefore, this systematic review was carried out to compare the effects of blood transfusion to HU therapy in preventing stroke for children with sickle cell disease. There was an extensive literature search in reliable and authentic databases like PubMed, Medline, Scopus, Cochrane, and Science Direct to obtain relevant articles. This study used the standards and guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). During the systematic review, data were obtained focusing on the following parameters: the size of the sample in the study, the age of the subjects involved in the study, the type of Intervention, and the outcome. After an initial search of 163 papers, 25 studies were included. The results of the research give the first evidence that HU is effective in the treatment of cerebrovascular problems in children with SCD. However, it is unclear under what circumstances HU may prevent a second stroke. It can be concluded that children with SCA can effectively avoid primary strokes through chronic blood transfusions and HU.

Readiness to change among parents of overweight/obese children in Saudi Arabia and influencing factors.

Background: Pediatric overweight/obesity is a major health problem worldwide. Accurate parental perception of children's weight status is crucial in preventing and tackling this issue. Despite the consistent increase in prevalence of the childhood obesity in Saudi Arabia, the role of the parents is not well described. This study aims to explore Saudi parents' readiness to change the lifestyle of their overweight/obese children and the barriers facing it. Individuals and Methods: Through a cross-sectional design, 362 parents of overweight/obese children attending King Abdulla Specialized Children's Hospital were selected and requested to fill a predesigned questionnaire reflecting their perception about their children's weight status and their preparedness to change their lifestyle. A Chi-square test was used to verify significance. A P value of <0.05 was considered an indication of significance. Results: Among all overweight/obese children (n = 362), obese children formed 39.5 and 22.7% had morbid obesity. Only one half of the parents (49.7%) had correct perception about their children's weight. Correct perception increases significantly with an increase age of the child and in the presence of family history of diabetes, P < 0.05. Only 68.9% were worried about body weight of their children, the percentage was significantly higher in younger parents; parents with obese children and with a positive family history of hypertension P < 0.05. In total, 83.1% of the worried parents proceeded to preparation and action stages; the percentage was significantly higher among parents whom their children were free from identified comorbidities, P < 0.05. Conclusion: Misconception about real weight status of overweight/obese children is common in Saudi parents. Parents who have correct perception and worried about health status of their children are more likely to take actions. The first step in controlling children's obesity is to educate parents about how to recognize the real weight status of their children and to be aware about the health-related problems of obesity.

The marginal effects of economic growth, financial development, and low-carbon energy use on carbon footprints in Oman: fresh evidence from autoregressive distributed lag model analysis.

Oman is committed to turning carbon neutral by 2040 whereby identifying the environmental sustainability-stimulating factors has become a critically important agenda for the nation. Against this backdrop, this study attempts to evaluate the marginal effects of economic growth, financial development, and low-carbon energy use on Oman's carbon footprint levels using quarterly frequency data spanning from 1984Q1 to 2018Q4. Controlling for structural break concerns in the data, the results from the empirical analysis verify the carbon footprint-related environmental Kuznets curve hypothesis for Oman in the long-run. In this regard, the threshold level of per capita real GDP level of Oman is predicted at around US $23,500 which is below the average and maximum per capita real GDP level of Oman during the period considered in this study. Besides, the development of the financial sector and scaling up consumption of low-carbon energy resources are evidenced to boost and curb Oman's short- and long-run carbon footprint figures, respectively. More importantly, the joint carbon footprint-mitigating impact of financial development and low-carbon energy use is also unearthed from the findings. In line with these major findings, a couple of relevant policy interventions are suggested to help Oman accomplish its 2040 carbon-neutrality agenda.

Training pediatric residents in point-of-care ultrasound: An assessment of the needs and barriers to acquire the skill.

Introduction: The use of point-of-care ultrasound (POCU) is increasing globally. However, owing to the epidemiology of diseases and local management strategies, POCU may not be universally applicable. Before developing a POCU training program, because of limited resources for medical education, it was pivotal to conduct a needs assessment and identify the training barriers. Methods: This study used a validated paper questionnaire. The survey instrument was distributed to 120 pediatric residents (male 60, female 60) training at our institution to assess their self-reported level of skill in POCU, and their perceptions with regard to the applicability of POCU, measured with a 5-point Likert scale. The skills deficit was measured by subtracting the self-reported level of skills in lung, cardiac, and abdominal POCU from the perceived applicability of POCU. Results: Fifty-nine residents participated, resulting in a response rate of 50 and 48% (n = 29) for the male group, and 50% (n = 30) for the female group. The level of knowledge and proficiency was low. Scanning for free abdominal fluid was deemed the most applicable (mean 4.2 ± SD 1.1); however, the use of POCU to detect consolidation was considered least applicable (mean 2.7 ± SD 1.3). The skills deficit was highest for an abdominal POCU (mean 2.4 ± SD 1.6) and lowest for lung ultrasound (mean 1.4 ± SD 1.6). Although the majority (n = 48) agreed that this skill was essential, 3 (5%) had no interest, and 39% (n = 23) indicated a lack of time to acquire the skill. Conclusions: Though pediatric residents in Saudi Arabia agree that POCU is an essential skill, large skill deficits exist, supporting the necessity to provide POCU training. However, there are several barriers to overcome to achieve this.

Residents and staff perceptions of a pediatric clinical teaching unit in a large tertiary care center in Saudi Arabia.

BACKGROUND: The clinical teaching unit (CTU) is a commonly used model of patient care and teaching. Despite being a common model of care, very few studies have looked at its impact on the education of trainees. In addition, it is a relatively new structure for pediatric inpatient care in Saudi Arabia. The purpose of this study was to compare postgraduate trainees (residents) and staff perceptions of the old and the new (the CTU) inpatient team structures, and to evaluate the impact of the CTU on residents' education. METHODS: An online survey was sent to nurses, pediatric residents, and attending physicians who worked under both structures. Questions for residents were adopted from the National training survey of the General Medical Council, United Kingdom. RESULTS: A total of 147 pediatric healthcare workers completed the survey (97 nurses, 39 residents, and 11 attending physicians), most of whom worked in both the old and new inpatient team structures. More than 97% of residents reported being supervised by their attending on a daily basis in the CTU structure as compared with 15% in the old structure. A higher proportion of residents favored the old structure in terms of the opportunity it provided to develop their leadership skills. Eighty-seven percent of nurses believed the CTU had improved patient safety of pediatric inpatients. Overall, 82% of residents, 91% of nurses, and 100% of attending physicians favoured the CTU structure over the old inpatient model. CONCLUSIONS: Our study shows that pediatric residents and staff perceived the CTU structure as superior to the old inpatient team structure, especially in terms of patient safety. Although the CTU seemed to have a positive impact on residents' education, this must be further examined especially with respect to its impact on residents' leadership skills.

A Comparison Between the Complications of Laparoscopic and Open Gastrostomy Tube Insertions: A Single-Center Study From Riyadh, Saudi Arabia.

Background and objective Gastrostomy is a procedure that involves placing a feeding tube through the abdominal wall into the stomach to provide nutritional support. There are several modes of gastrostomy tube insertion including laparoscopic-assisted gastrostomy (LAG), percutaneous endoscopic gastrostomy (PEG), and open gastrostomy (OG) procedure, among others. Although it is a widely performed procedure, limited data is available regarding gastrostomy in Saudi Arabia, specifically among the pediatric population. This study aimed to shed more light on different aspects of surgical gastrostomy procedures among pediatric patients at the King Abdullah Specialist Children's Hospital (KASCH) in Riyadh, Saudi Arabia. The main objective of our study was to report the indications and complications of both LAG and OG insertions in the pediatric population. Methods A retrospective cross-sectional study was conducted at KASCH to analyze the different parameters related to LAG and OG insertions, and to evaluate for any association between these modes of insertion and their complications. Pertinent data on children from birth to 14 years of age were collected through consecutive sampling using a chart review. A total of 107 pediatric patients who underwent the procedure from 2016 to 2020 were evaluated. Results Demographically, the majority (58%) of gastrostomies were performed in infants (less than a year old). Additionally, our study showed a significantly increased association between LAG and complications such as discharge, (27.12%), skin manifestations (27.12%), and bleeding (10.17%) when compared to OG. Conclusion Based on our findings, LAG showed less favorable outcomes in contrast to OG. Further studies should be conducted to validate our findings and ensure consistent results and outcomes among different methods of gastrostomy tube insertion.

Urinary Tract Infection in Children With Bronchiolitis: Is It Worth Testing Everyone?

Objective The current study aims to determine the prevalence of urinary tract infection (UTI) and the need to perform urine analysis and cultures in children admitted with bronchiolitis in a large tertiary children's hospital in Riyadh, Saudi Arabia. Methods We conducted a retrospective chart review of pediatric patients 0-2 years of age who were admitted with bronchiolitis from November 2016 till April 2017. All charts were analyzed to identify the children investigated for UTI, and their results were then reviewed. Results There were 407 children admitted with bronchiolitis during the study period. Two-thirds of them were investigated for UTI. Only 2.6% of the patients tested positive for urine culture, and only 0.96% were found to have a true UTI. Conclusion The prevalence of UTI in children with bronchiolitis is too low to justify routine screening. Therefore, only children with a high risk of having UTI should be investigated.

Use of Platelet-Rich Plasma in Treating Low Back Pain: A Review of the Current Literature

Low back pain (LBP) is a common problem encountered by physicians. It is a considerable cause of morbidity and socioeconomic loss and is one of the most expensive musculoskeletal disorders. Conventional treatments include bed rest, analgesics, therapeutic exercises, lumbar or caudal epidural corticosteroids, and surgery. Several new biological therapies are being investigated for use in LBP and one of these is platelet-rich plasma (PRP). In this article, we summarize the current literature published on PRP concerning its composition, classification, and application in LBP. We believe our review will prove useful to clinicians and academics alike, interested in new developing therapies for LBP.

Assessing parental awareness and attitudes toward leaving children unattended inside locked cars and the risk of vehicular heat strokes.

BACKGROUND: Vehicular heat stroke is considered as one of the preventable causes of non-crash, vehicle-related deaths among children. The prevalence of parents and caregivers leaving children unattended in enclosed vehicles is non-negligible. OBJECTIVE: This paper aims to assess parents' knowledge and beliefs about vehicular heat strokes among children in addition to the prevalence and associated factors of leaving children inside locked cars. METHODS: A cross-sectional study was carried out at King Abdullah Specialist Children's Hospital in Riyadh. Two hundred nine parents completed a self-administered questionnaire addressing vehicular heat strokes. RESULTS: Among the participants, 24.88% have left at least one of their children unattended inside locked cars during a sunny day; 78.85% of parents have heard about accidental deaths secondary to leaving children in locked vehicles. When assessing parental knowledge of increased sensitivity to heat in infants/children, 81.34% of them knew the correct information. Older age (P = .0150), less paternal education (P = .0157), and increased number of children (P = .0020) were associated with increased incidences of leaving children unattended in enclosed cars. CONCLUSION: Considering the high temperatures in the Gulf region, the prevalence of vehicular heat stroke secondary to locking children inside vehicles is nontrivial. Awareness programs for parents and caregivers are strongly encouraged.

Facile synthesis of N/B-double-doped Mn2O3 and WO3 nanoparticles for dye degradation under visible light.

In the present work, nitrogen-doped and nitrogen-boron-double-doped manganese oxide (Mn2O3) and tungsten oxide (WO3) nanoparticles were synthesized using precipitation-hydrothermal method for methylene blue degradation under visible light. Materials were characterized using X-ray diffraction (XRD) analysis, Scanning electron microscopy, Energy dispersive X-ray spectroscopy and UV-vis spectroscopy. Results showed that N and B were successfully incorporated into the crystal lattices of Mn2O3 and WO3. XRD showed that WO3 was crystallized in the form of a monoclinic lattice, while cubic Mn2O3 was produced in the cubic form. The crystallite size was found to be decreased due to the substitution of N and B elements which reveals their roles to accelerate the crystal nucleation rate resulting in the decreased size. On the other hand, single and double doping has successfully narrowed the band gaps of the as-synthesised metal oxide photocatalysts resulting in better absorption in the visible light. Band gaps obtained were as follows: 3.02, 2.50, 1.73 and 1.77 eV for N-WO3 N/B-WO3, N-Mn2O3 and N/B-Mn2O3 respectively. Photocatalytic experiments showed that all as-synthesised materials exhibited a photocatalytic efficiency under visible light ≥420 nm. The degradation efficiency of methylene blue (MB) was in the following order: N-B-co-doped metal oxides > N-doped metal oxides > metal oxides. The presence of scavenger molecules such as isopropanol, EDTA-2Na and benzoquinone inhibited MB degradation. Finally, the results showed that these materials can be reused several times without a notable decrease in efficiency.

Improved antifouling potential of polyether sulfone polymeric membrane containing silver nanoparticles: self-cleaning membranes.

A new strategy to enhance the antifouling potential of polyether sulfone (PES) membrane is presented. Chemically synthesized silver nanoparticles (AgNPs) were used to prepare a mixed-matrix PES membrane by the phase inversion technique. Primarily, AgNPs synthesis was confirmed by surface plasmon resonance at 410-430 nm using UV-Visible spectroscopy. X-ray diffraction analysis revealed that AgNPs were crystalline with a diameter of 21 ± 2 nm. Furthermore, PES membranes were characterized by energy dispersive X-ray spectroscopy to confirm the incorporation of AgNPs in membranes. Hydrophilicity of the membranes was enhanced, whereas roughness, mechanical strength and biofouling were relatively reduced after embedding the AgNPs. Antibacterial potential of AgNPs was evaluated for E. coli in the disc diffusion and colony-forming unit (CFU) count method. All of the membranes were assessed for antifouling activity by filtering a control dilution (106 CFU/ml) of E. coli and by counting CFU. Anti-biofouling activity of the membrane was observed with different concentrations of AgNPs. Maximum reduction (66%) was observed in membrane containing 1.5% of AgNPs. The addition of antibiotic ceftriaxone enhanced the antibacterial effect of AgNPs in PES membranes. Our practicable antifouling strategy may be applied to other polymeric membranes which may pave the new way to achieve sustainable and self-cleaning membrane reactors on large scale.

Recovery of metallo-tolerant and antibiotic resistant psychrophilic bacteria from Siachen glacier, Pakistan.

Cultureable bacterial diversity of previously unexplored Siachen glacier, Pakistan, was studied. Out of 50 isolates 33 (66%) were Gram negative and 17 (34%) Gram positive. About half of the isolates were pigment producers and were able to grow at 4-37°C. 16S rRNA gene sequences revealed Gram negative bacteria dominated by Proteobacteria (especially γ-proteobacteria and ß-proteobacteria) and Flavobacteria. The genus Pseudomonas (51.51%, 17) was dominant among γ- proteobacteria. ß-proteobacteria constituted 4 (12.12%) Alcaligenes and 4 (12.12%) Janthinobacterium strains. Among Gram positive bacteria, phylum Actinobacteria, Rhodococcus (23.52%, 4) and Arthrobacter (23.52%, 4) were the dominating genra. Other bacteria belonged to Phylum Firmicutes with representative genus Carnobacterium (11.76%, 2) and 4 isolates represented 4 genera Bacillus, Lysinibacillus, Staphylococcus and Planomicrobium. Most of the Gram negative bacteria were moderate halophiles, while most of the Gram positives were extreme halophiles and were able to grow up to 6.12 M of NaCl. More than 2/3 of the isolates showed antimicrobial activity against multidrug resistant S. aureus, E. coli, Klebsiella pneumonia, Enterococcus faecium, Candida albicans, Aspergillus flavus and Aspergillus fumigatus and ATCC strains. Gram positive bacteria (94.11%) were more resistant to heavy metals as compared to Gram negative (78.79%) and showed maximum tolerance against iron and least tolerance against mercury.

Vertebral osteomyelitis and epidural abscesses caused by Prevotella oralis: a case report

An interesting case of pyogenic vertebral osteomyelitis with multiple epidural abscesses caused by non-pigmented Prevotella oralis is reported. The patient was a 68-year-old female who presented to the emergency room (ER) with severe pain and tenderness in her lower back with fever. She had recently undergone esophagogastroduodensoscopy (EGD) for complaints of esophageal reflux, which showed submucosal cyst in the esophagus. Magnetic resonance imaging (MRI) of the thoracic spine revealed multiple spinal epidural abscesses with signal enhancement at the level of T6 and T7, suggestive of vertebral osteomyelitis. Two blood cultures drawn one hour apart grew Prevotella oralis. The body fluid aspirated from the abscesses was also positive for the anaerobic commensal P. oralis. Necrosis associated with the submucosal cyst was implicated as the cause of sepsis and osteomyelitis due to this organism.