Bacillus velezensis
is a plant growth-promoting bacterium that can also inhibit plant pathogens. However, based on its properties, it is emerging as a probiotic in animal feed. This review focuses on ...the potential characteristics of
B. velezensis
for use as a probiotic in the animal feed industry. The review was conducted by collecting recently published articles from peer-reviewed journals. Google Scholar and PubMed were used as search engines to access published literature. Based on the information obtained, the data were divided into three groups to discuss the (i) probiotic characteristics of
B. velezensis
, (ii) probiotic potential for fish, and (iii) the future potential of this species to be developed as a probiotic for the animal feed industry. Different strains of
B. velezensis
isolated from different sources were found to have the ability to produce antimicrobial compounds and have a beneficial effect on the gut microbiota, with the potential to be a candidate probiotic in the animal feed industry. This review provides valuable information about the characteristics of
B. velezensis
, which can provide researchers with a better understanding of the use of this species in the animal feed industry.
Background Despite vaccine and antiviral treatment availability, hepatitis B virus (HBV) continues to circulate among pregnant women in Iraq. HBV spread is due to many factors. This study evaluated ...HBV prevalence among pregnant women and Syrian refugees residing in Zakho city, Iraq, and identified risk factors associated with infection. Materials and methods Demographic data were collected from 2,054 pregnant women via a questionnaire assessing risk factors associated with HBV infection. Blood samples were collected for hepatitis B surface antigen (HBsAg) and were screened using an enzyme-linked immunosorbent assay. Results Tests revealed that 1.1% of pregnant women in Zakho and 11.3% of Syrian refugees (p = 0.001) were positive for HBsAg. The average age of HBsAg-positive patients was 31.4286 ± 6.6746 years (p = 0.002). Average rates of parity and abortion in HBV-infected subjects were 3.5 ± 2.6874 and 0.1785 ± 0.5479, respectively (p = 0.044 and 0.012, respectively). The following were identified as associated risk factors for HBV infection: nationality, (Zakho versus the city centre), tattoos, and polygamy (p = 0.001, 0.03, 0.007, and 0.001, respectively). No significant associations between HBV prevalence and blood transfusion, prior injection history, dental procedures, or surgical procedures were found. Conclusion The prevalence of HBV infection among Syrian refugees was higher than that of indigenous participants. Several risk factors were significantly associated with HBV positivity, which may facilitate effective preventive program implementation and decrease mother-to-child transmission risk. This will likely reduce infant and childhood HBV chronicity, and mortality rates.
Data regarding the outcomes of restarting anticoagulation in patients who develop gastrointestinal bleeding (GIB) while anticoagulated are sparse. We hypothesized that restarting anticoagulation in ...these patients is associated with better outcomes. This is a retrospective cohort study that enrolled subjects who developed GIB while on anticoagulation from 2005 to 2010. Atrial fibrillation was defined by history and electrocardiography on presentation. GIB was defined as a decrease in hemoglobin by 2 g, visible bleeding, or positive endoscopic evaluation. Time-to-event adjusted analyses were performed to find an association of restarting warfarin and recurrent GIB, arterial thromboembolism, and mortality. Stratified analysis by duration of interruption of warfarin was also performed. Overall, 1,329 patients (mean age 76 years, women 45%) developed major GIB. Warfarin was restarted in 653 cases (49.1%). Restarting warfarin was associated with decreased thromboembolism (hazard ratio HR 0.71, 95% confidence interval CI 0.54 to 0.93, p = 0.01) and reduced mortality (HR 0.67, 95% CI 0.56 to 0.81, p <0.0001) but not recurrent GIB (HR 1.18, 95% CI 0.94 to 1.10, p = 0.47). When the outcomes were stratified by duration of warfarin interruption, restarting warfarin after 7 days was not associated with increased risk of GIB but was associated with decreased risk of mortality and thromboembolism compared with resuming after 30 days of interruption. Decision to restart warfarin after an episode of major GIB is associated with improved survival and decreased thromboembolism without increased risk of GIB after 7 days of interruption.
Article 14 of the WHO 'Framework Convention on Tobacco Control' recommends, that all oral healthcare providers provide support for tobacco cessation, to all patients. Despite evidence on the ...effectiveness of tobacco cessation interventions in dental settings, implementation remains low in most high-burden countries like Pakistan. A pragmatic pilot trial of a dentist-delivered behavioural support intervention for smokeless tobacco (ST) cessation, was conducted in dental hospitals in Pakistan. This paper presents the findings of the process evaluation of the trial.
A mixed-method process evaluation of a multi-centre randomised control pilot trial of dentist-delivered behavioural support intervention ST cessation was conducted. The intervention included three sessions namely: pre-quit, quit and post-quit sessions. The process evaluation involved: semi-structured interviews with trial participants (n = 26, of which dental patients were n = 13 and participating dentists were n = 13 conducted from June-August 2022); and fidelity assessment of audio recordings of the intervention sessions (n = 29). The framework approach was used to thematically analyse the interview data.
Overall the trial procedures were well accepted, however, young patients expressed uneasiness over revealing their ST use status. The intervention was received positively by dentists and patients. Dentists identified some challenges in delivering behavioural support to their patients. Of these, some were related to the contents of the intervention whereas, others were related to the logistics of delivering the intervention in a clinical setting (such as workload and space). Acceptability of the intervention resources was overall low amongst young patients as they did not take the intervention resources home due to fear of their family members finding out about their ST use. The intervention was successful in achieving the intended impact (in those who engaged with the intervention), i.e., change in the patients' ST use behaviour. Giving up ST with the aid of behavioural support also had an unintended negative effect i.e., the use of harmful substances (cannabis, cigarettes) to give up ST use. Patients' satisfaction with their dental treatment seemed to influence the intervention outcome.
While there are many variables to consider, but for the participants of this study, behavioural support for abstinence delivered through dentists during routine dental care, appears to be an acceptable and practical approach in helping patients give up ST use, in a country like Pakistan, where negligible support is offered to ST users.
The tropical environment of Sudan promotes the spread of mosquito-transmitted diseases such as dengue virus (DENV) infection. The current understanding of the geographical distribution of DENV ...serotypes and genotypes in Sudan is limited. In this study, molecular techniques (reverse transcriptase RT-PCR and sequencing) followed by phylogenetic analysis were used to characterize DENV isolated from the blood samples of suspected dengue patients admitted to Kassala Hospital, Kassala state, Sudan, in 2016 and 2017. We identified DENV infection in 4 patients by RT-PCR. Phylogenetic analysis revealed that the isolated virus sequences belong to the Cosmopolitan genotype of DENV serotype 2. This is the first study to confirm the presence of DENV serotype 2 in Kassala state, Sudan. Our results indicate the need for wider investigations of the DENV serotype composition and studies to evaluate their contribution to ongoing transmission.
The emergence of COVID-19 caused a significant global threat, affecting populations worldwide. Its impact extended beyond just physical health, as it inflicted severe damage and challenges to ...individuals' well-being, leading to a deterioration in mental health. The lived experiences of patients hold a paramount position to explore and understand their perception of care which can ultimately strengthen the health system's delivery domain. This study explores the lived experiences of patients in the isolation ward, their recovery, and the quality of care being provided in the hospital and its effects on their mental health.
A phenomenological qualitative study using in-depth interviews.
We conducted 11 in-depth interviews of COVID-19 patients admitted to the isolation ward of the public hospitals of Peshawar, Pakistan. Participants who stayed for a minimum of 10 days in an isolation ward were included in this study. Interviews were transcribed and analyzed using NVivo 12 software and generated five themes through inductive analysis.
Five themes emerged from the participants' lived experiences: Heading towards the hospital, Health Care Quality, Impact on Mental Health, Recovering from COVID-19 and Back on one's feet. These included all the positive and negative lived experiences. Socio-environmental factors along with their experiences of the disease itself and with the healthcare providers guided their reaction which was important conciliators in their experiences during the pandemic.
Based on the findings, the environment of isolation had a major influence on the mental well-being of the individuals involved. Considering the important role of the ward environment in shaping patient experiences and outcomes prompts a reevaluation of healthcare practices and policies. By addressing these factors healthcare systems can strive for greater effectiveness, resilience, and compassion in managing the pandemic's impact on patient care.
Therapeutic effects of anticancer medicines can be improved by targeting the specific receptors on cancer cells. Folate receptor (FR) targeting with antibody (Ab) is an effective tool to deliver ...anticancer drugs to the cancer cell. In this research project, a novel formulation of targeting drug delivery was designed, and its anticancer effects were analyzed. Folic acid-conjugated magnetic nanoparticles (MNPs) were used for the purification of folate receptors through a novel magnetic affinity purification method. Antibodies against the folate receptors and methotrexate (MTX) were developed and characterized with enzyme-linked immunosorbent assay and Western blot. Targeting nanomedicines (MNP-MTX-FR Ab) were synthesized by engineering the MNP with methotrexate and anti-folate receptor antibody (anti-FR Ab). The cytotoxicity of nanomedicines on HeLa cells was analyzed by calculating the % age cell viability. A fluorescent study was performed with HeLa cells and tumor tissue sections to analyze the binding efficacy and intracellular tracking of synthesized nanomedicines. MNP-MTX-FR Ab demonstrated good cytotoxicity along all the nanocomposites, which confirms that the antibody-coated medicine possesses the potential affinity to destroy cancer cells in the targeted drug delivery process. Immunohistochemical approaches and fluorescent study further confirmed their uptake by FRs on the tumor cells' surface in antibody-mediated endocytosis. The current approach is a useful addition to targeted drug delivery for better management of cancer therapy along with immunotherapy in the future.
Introduction
Interventional Neurology (IN) is a rapidly expanding field, with new devices and techniques broadening the range of cerebrovascular diseases that can be treated (1). Despite this, ...medical students are not commonly exposed to IN either during their preclinical years or neurology clerkship. Other reports have indicated significant interest in IN through neurology residency despite a poorly structured pathway to the career (2). There remains a paucity of educational focus on endovascular specialties among medical schools; simulation‐based approaches present an opportunity to address this (3‐5). We piloted an engaging didactic and hands‐on Mentice® Neuroendovascular simulation seminar to increase awareness and interest in IN.
Methods
Through the Student Interest Group in Neurology (SIGN) at Emory School of Medicine, we recruited 20 students (55% M1, 5% M2, 30% M3, 10% M4; 50% female) to participate in an IN didactic and simulation seminar. Before and after the seminar, participants were administered a 28‐question survey regarding their knowledge of and interest in a career in IN. All participants provided consent. A didactic session led by a fellowship trained Interventional Neurologist and a simulation session including 3 stations: diagnostic angiography, thrombectomy, and aneurysm coiling. All participants rotated at all 3 stations and all questions were answered.
Results
The survey was broken into subjective and objective questions regarding student interest, familiarity, and knowledge of IN. The subjective questions were recorded on Likert scales from 1‐5 while objective questions focused on endovascular procedures and their indications. Exposure to IN was limited; 70% of medical students reported no formal exposure to the field. Prior to the event, only 30% of students were interested or very interested (4 or 5 on Likert scales) in a career in IN compared to 50% post‐survey. 20% of students felt familiar or very familiar with the field prior to the seminar compared to 50% post‐survey. More students recognized the training pathways to Neurointervention (Radiology, Neurosurgery, and Neurology), could name at least 3 IN procedures, and showed improved knowledge of basic IN treatments and pathology after the event.
Conclusion
Interventional Neurology remains a relatively new field and is often not included in traditional medical student curriculums, even at sites where training occurs within a Comprehensive Stroke Center. Our survey demonstrated the lack of knowledge and comfort level regarding IN amongst medical students. Uniquely curated seminars targeted at medical students can lead to an increase in awareness and interest in IN (6‐8). Early exposure has been shown to increase recruitment and dispel erroneous assumptions about the specialty (4). We believe these survey results show the importance of incorporating lecture and simulation based IN procedures for medical students, especially those interested in procedural specialties. Increasing students’ knowledge of IN also provides a better understanding of career options in neurology and the extent of therapeutic options a neurologist can offer patients (2,4).
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