A frequent source of milk contamination is Bacillus cereus. The microorganism can contaminate raw milk at the time of milking since it is ubiquitous in the environment. In the current study, one ...hundred raw milk samples were obtained from farmers, supermarkets, street vendors and dairy shops in Egypt, collected samples were examined biochemically and by vietk 2 compact system to isolate Bacillus cereus. Prevalence values of B. cereus were 0, 20,8 and 12% respectively. The Mean ± SE of the pH values for milk samples were 6.54 ± 0.04, 6.48 ± 0.06, 6.44 ± 0.05 and 6.53 ± 0.06 respectively, on the other hand sorch’s test for milk samples was positive in a percentage of 12, 8, 40 and, 16, respectively. Molecular characterization of hlbA and ces showed positive reaction for 30 and 20% of samples. Growth, proteolytic and lipolytic activities of Bacillus cereus was 100, 100, 20 and 40, 40, 20 at 30◦C/48 h and 7°C/10 days, respectively. Outcomes of the in vitro testing for susceptibility indicated that the highest resistance to antibiotics was against macrolides and mono, B-lactamase, whereas moderate resistance was exhibited to gentamicin. The current study's findings exhibited evidence of B. cereus isolation from raw milk has a high potential for producing food poisoning, so it is necessary to employ the techniques to lessen bacterial contamination while processing dairy products.
Biliary complications (BCs) after liver transplantation (LT) remain a considerable cause of morbidity, mortality, increased cost, and graft loss.
To investigate the impact of BCs on chronic graft ...rejection, graft failure and mortality.
From 2011 to 2016, 215 adult recipients underwent right-lobe living-donor liver transplantation (RT-LDLT) at our centre. We excluded 46 recipients who met the exclusion criteria, and 169 recipients were included in the final analysis. Donors' and recipients' demographic data, clinical data, operative details and postoperative course information were collected. We also reviewed the management and outcomes of BCs. Recipients were followed for at least 12 mo post-LT until December 2017 or graft or patient loss.
The overall incidence rate of BCs including biliary leakage, biliary infection and biliary stricture was 57.4%. Twenty-seven (16%) patients experienced chronic graft rejection. Graft failure developed in 20 (11.8%) patients. A total of 28 (16.6%) deaths occurred during follow-up. BCs were a risk factor for the occurrence of chronic graft rejection and failure; however, mortality was determined by recurrent hepatitis C virus infection.
Biliary complications after RT-LDLT represent an independent risk factor for chronic graft rejection and graft failure; nonetheless, effective management of these complications can improve patient and graft survival.
BACKGROUNDDespite significant advancements in liver transplantation (LT) surgical procedures and perioperative care, post-LT biliary complications (BCs) remain a significant source of morbidity, ...mortality, and graft failure. In addition, data are conflicting regarding the health-related quality of life (HRQoL) of LT recipients. Thus, the success of LT should be considered in terms of both the survival and recovery of HRQoL. AIMTo assess the impact of BCs on the HRQoL of live-donor LT recipients (LDLT-Rs). METHODSWe retrospectively analysed data for 25 LDLT-Rs who developed BCs post-LT between January 2011 and December 2016 at our institution. The Short Form 12 version 2 (SF 12v2) health survey was used to assess their HRQoL. We also included 25 LDLT-Rs without any post-LT complications as a control group. RESULTSThe scores for HRQoL of LDLT-Rs who developed BCs were significantly higher than the norm-based scores in the domains of physical functioning (P = 0.003), role-physical (P < 0.001), bodily pain (P = 0.003), general health (P = 0.004), social functioning (P = 0.005), role-emotional (P < 0.001), and mental health (P < 0.001). No significant difference between the two groups regarding vitality was detected (P = 1.000). The LDLT-Rs with BCs had significantly lower scores than LDLT-Rs without BCs in all HRQoL domains (P < 0.001) and the mental (P < 0.001) and physical (P = 0.0002) component summary scores. CONCLUSIONThe development of BCs in LDLT-Rs causes a lower range of improvement in HRQoL.
This study aims identify E. coli and its β-lactamase encoding genes, S. aureus and its enterotoxin genes isolated from milk and Kariesh cheese. Moreover, we evaluated the antibacterial effect of ...lactoferrin against these pathogenic bacteria. Sixty samples in total (30 each of raw milk and Kariesh cheese) were collected from various retail-markets in Kafrel-Sheikh Governorate. The percentage of E. coli isolates found in raw milk and Kariesh cheese reached 43.3% and 36.6%, respectively, while S. aureus isolates were recorded at 50% and 23.3% (from raw milk and Kariesh cheese). Twenty-four strains of E. coli were serogrouped, of which 3 strains out of 24 were O17, O91 and O159, 6 strains were O127 and 9 strains were O26. PCR analysis for β-lactamase encoding genes in E. coli indicated that all eight isolates were 100% positive for blaTEM and blaSHV genes while 5 (62.5%) S. aureus isolates were positive for enterotoxin production. Five (62.5%) isolates produced Seb, 2(25%) produced Sec while the Sea gene was not detected in S. aureus isolates. The results indicate that lactoferrin 5% had a significant inhibitory effect on S. aureus and E. coli when they were inoculated into Kariesh cheese. The findings show that dairies didn't take enough hygiene precautions, and we advise following stringent hygiene procedures when dairy products are milked, processed and distributed. To control the growth of E. coli and S. aureus in dairy products,lactoferrin is thought to be a potential strategy.
Food additives spread around the world may have potentially harmful effects; Propolis is considered a natural additive that meets the increasing demand for natural antioxidants and antimicrobials in ...place of synthetic preservatives. Different concentrations of water extract of Propolis (WEP) were assessed; the pH and microbiological quality of raw milk were evaluated, as well as the quality characteristics and bioactives in manufactured yoghurt. WEP 20% was the best concentration compared to WEP 5% and 10% and exhibited an acceptable pH value of milk for 48 hours. The addition of increased concentrations of WEP 20% (1, 2, and 3%) resulted in a significant decrease and gradual reduction of the total bacterial, coliform, yeast, and mold counts compared to the control group. Propolis-supplemented yoghurt had higher pH values than the control group. Yoghurt groups treated with 1% and 2% WEP achieved the highest scores and significantly different (P<0.05) with control and 3% WEP groups in sensory examination until the end of the storage period. Furthermore, the counts of yeast and mold progressively decreased with the addition of higher concentrations of WEP throughout the storage period as 2%, 3% WEP groups were significantly different (P<0.05) with control and 1% WEP groups. The total phenolic, flavonoid content and antioxidant activity of yoghurt treated with WEP were improved and significantly different (P<0.05) compared to the untreated group. In conclusion, the raw milk and yoghurt preserved with propolis improved the quality of milk and increased bioactivity and nutritional benefits of yoghurt by elevating its antioxidant capacity. As a consequence, the produced yoghurt in our study proved that it is an acceptable product with functional, probiotic potential and has health-promoting properties that might be commercialized.
This project aims to prepare hydrogel microneedle patches (MNs) as a painless method to deliver carbamazepine transdermally. This can be used as a sustained release system that offers the advantages ...of lower gastrointestinal side effects and avoids the first-pass metabolism of the drug. MNs were composed of two medicated layers, a microneedle layer and a base layer. MNs were fabricated using polyvinyl alcohol with or without polyvinylpyrrolidone Kollidon 30 as a matrix polymer and in the presence of selected solubilizing agent (polyethylene glycol 400, Tween 80, or α-tocopherol polyethylene glycol). Freezing–thawing cycle was evaluated as one of the processing parameters that may affect the drug release. The MNs were evaluated for their weight variation, base thickness, and content uniformity. The physicochemical compatibility between carbamazepine and the polymers was estimated by Fourier transform infrared spectroscopy, differential scanning calorimetry, thermogravimetric analysis, and X-ray powder diffraction. Evaluation for the
in vitro
release studies and
ex vivo
permeation studies was performed. The prepared MNs were flexible, clear, and uniform in weight, base thickness, and drug content. Physicochemical characterizations showed that carbamazepine was amorphous in most of the MNs.
In vitro
release and
ex vivo
permeation studies of carbamazepine were significantly higher for MNs containing a combination of 1:1 w/w of PEG 400 and Tween 80 as solubilizing agents where the release was extended over 96 h, with the release of 85.2% and 59.6% permeation percentage compared to other MNs. A significant effect of the freezing–thawing cycle on the release profile of the drug was observed. The hydrogel MNs are shown to be stable under the studied storage conditions.
Graphical Abstract
Formation of bacterial biofilm on indwelling urinary catheters usually causes catheter–associated urinary tract infections (CAUTIs) that represent high percent of nosocomial infections worldwide. ...Therefore, coating urinary catheter with antibacterial and antifouling coating using facile technique is in great demand. In this study, commercial urinary catheter was coated with a layer of the self-polymerized polydopamine which acts as active platform for the in situ formation of silver nanoparticle (AgNPs) on catheter surface. The formed coating was intensively characterized using spectroscopic and microscopic techniques. The coated catheter has the potential to release silver ion in a sustained manner with a concentration of about 2–4 μg ml−1. Disk diffusion test and colony forming unites assay verified the significant bactericidal potential of the AgNPs coated catheter against both gram–positive and gram–negative bacteria as a consequence of silver ion release. In contrast to commercial catheter, the AgNPs coated catheter prevented the adherence of bacterial cells and biofilm formation on their surfaces. Interestingly, scanning electron microscope investigations showed that AgNPs coated catheter possess greater antifouling potential against gram–positive bacteria than against gram–negative bacteria. Overall, the remarkable antibacterial and antifouling potential of the coated catheter supported the use of such facile approach for coating of different medical devices for the prevention of nosocomial infections.
Materials science; Nanomaterials; Coatings; Materials characterization; Supramolecular chemistry; Urology; Urinary catheters; Polydopamine; Silver nanoparticle; Antibacterial; Antifouling
Induction of general anaesthesia is commonly associated with hypotension. This exposes patients to perioperative organ hypoperfusion and eventually damage. This study was designed to assess the ...ability of preoperative perfusion index (PI), plethysmographic variability index (PVI), and dicrotic plethysmography (Dicpleth) to predict hypotension after induction of general anaesthesia.
In this cohort study, 95 ASA I and II adult patients who were scheduled for elective surgery under general anaesthesia were enrolled. The correlation between preoperative PI, PVI, Dicpleth and percentage decrease in mean arterial blood pressure after anaesthesia induction was investigated. Ability of PI, PVI, Dicpleth to detect post-induction hypotension was also analysed.
The percent decrease in MAP after anaesthesia correlated with baseline PI (r = -0.45, P < 0.001), PVI (r = 0.45, P = 0.001) and Dicpleth (r = 0.16, P = 0.12). The PI cut-off value was ≤ 3.03 for a patient at risk for post-induction hypotension with 77.8% sensitivity, 75% specificity, positive and negative predictive values of 74.5% and 78.3%, respectively. Similarly, the ROC analysis revealed that baseline PVI (AUC = 0.73, 95% CI = 0.622-0.812) was suitable for detecting post-induction hypotension. Moreover, baseline Dicpleth (AUC = 0.63) showed significant predictive ability.
The pre-anaesthetic PI and PVI 17, respectively, have a good ability to predict those at risk of developing post-induction hypotension in adult patients undergoing elective surgery under general anaesthesia. Future studies are needed in order to investigate the usefulness of Dicpleth in different circumstances during anaesthesia. Clinical trial registration ID: The study was registered at clinicaltrials.gov (NCT04217226).
Background
Clinical pharmacy services started in 2009 at the National Center for Cancer Care and Research, Qatar. Clinical pharmacy services was established to provide comprehensive prescription of ...drug management and support, and consulting services to build clinically efficient and cost-effective pharmacy program.
Aim
To determine perceptions and expectations of healthcare providers toward the clinical pharmacy services at the National Center for Cancer Care and Research.
Methods
A cross-sectional survey of healthcare providers was conducted from January to May 2018. A self-administered electronic/paper survey containing four domains assessing healthcare providers’ perceptions and expectations towards clinical pharmacy services, perceived barriers to clinical pharmacist role and suggested area for improvement was sent to 375 healthcare providers including physicians, operational pharmacists, nurses and dietitians.
Results
The response rate was 112/375. Most of the healthcare providers (74%) perceived the increasing interest in clinical pharmacy services. Also, they expected (1) providing consultations regarding appropriate medication choices (82%); (2) providing information about medication availability and shortages (82%); (3) assisting in the prescribing of cost-effective drugs by providing pharmacogenomics information routinely (75%) and (4) Participating actively in research activities (74%). Overall, healthcare providers have a high level of trust in the clinical pharmacists’ abilities (P < 0.01). Nurses were less appreciative (P < 0.002) of the positive role of clinical pharmacists in direct patient care as compared to both physicians and pharmacists (64.2%, 90% and 95.7%, respectively).
Conclusion
This study revealed a positive attitude towards the role of clinical pharmacists by healthcare providers at National Center for Cancer Care and Research. However, there is an area of improvement by empowering with privilege and staffing, elevating the awareness and expansion in the ambulatory care settings.
PDF
