The practice of dispensing non-prescribed antibiotics aggravates the global burden of antibiotic resistance. The objective of this study is to assess the practice of community pharmacists regarding ...dispensing antibiotics without a prescription based on simulated clinical scenarios.
Cross-sectional study.
The study was performed between 15 April to 18 June 2015. Five different clinical scenarios were simulated, involving sore throat, otitis media, cough, diarrhea, and urinary tract infection (UTI). Three different levels of demand were used to convince the pharmacists to dispense antibiotics data was analyzed using SPSS, version 21.0.
Two-hundred community pharmacies in Sana'a were visited for each clinical scenario. The majority of pharmacies (73.3%) dispensed antibiotics without medical prescriptions in different levels of demand. Most antibiotics were dispensed for the sore throat simulated scenario (99.5%), followed by cough (92%), diarrhea (75.5%), and otitis media (52%). The lowest percentage of dispensed antibiotics was in the UTI scenario, with 48%. Among the pharmacists who dispensed antibiotics, 74.2% provided an explanation to the simulated patients regarding how to use antibiotics, 77.6% counseled the patient about treatment duration and only 11.9% of the pharmacists asked about the pregnancy status. Regarding the cough scenario, 83% of the pharmacists inquired about the type of cough before dispensing medication.
Antibiotics in Yemen can be easily obtained without medical prescription or evidence-based indication.
•This study explores the antibiotics dispensing pattern in Yemen during the current crises.•Dispensing antibiotics without a prescription may contribute consequently to antibiotic resistance within the Yemeni community.•Such resistance may later become a global threat, since regional resistance may spread globally.
Aims
The aim of this study was to isolate and characterize staphylococcal isolates from diabetic foot ulcers (DFU) in Jordanian patients.
Methods and Results
Selected aerobic pathogens recovered from ...DFU specimens and patients' nares with a focus on staphylococci were investigated. Antimicrobial susceptibilities and the prevalence of methicillin‐resistant staphylococci (MRS) were determined. SCCmec types and toxigenic characteristics were analysed and spa typing was performed for methicillin‐resistant Staphylococcus aureus (MRSA) isolates. The relationship between toxigenic characteristics of MRSA and the Wagner ulcer grading system was statistically analysed. A total number of 87 DFU patients were recruited for the study. The DFU cultures were polymicrobial. Members of the genus Staphylococcus were the most common among DFU‐associated isolates found in 48·3% (n = 42) of all patients enrolled. Coagulase‐negative staphylococci (CoNS) comprised 63·3% of staphylococci isolated from DFUs predominated by Staphylococcus epidermidis in both DFU (7·6%) and nares (39·2%). Staphylococcus aureus was isolated from DFUs and nares in 14·2 and 9·8%, respectively, while 93 and 70% of these isolates were MRSA. Most of MRSA carried SCCmec type IV (76·2%) while SCCmec elements were non‐typeable in most methicillin resistant coagulase negative staphylococci (MR‐CoNS) (61·9%). The most frequent MRSA spa type was t386 (23·8%). Most MRSA and MR‐CoNS exhibited resistance towards aminoglycosides, fluoroquinolones and macrolides and susceptibility towards vancomycin, mupirocin and linezolid. No association was found between the possession of pvl, tst, sea and hlg toxins and Wagner ulcer grading system (P value >0·05).
Conclusions
This analysis of Jordanian DFU culture demonstrated its polymicrobial nature with predominance of Staphylococcus sp.
Significance and Impact of the Study
This study is the first of its type to assess the microbiology of DFU among Jordanian patients. The results will help in the appropriate application of antimicrobial chemotherapy in the management of DFU.
Coronavirus Disease 2019 (COVID-19) is a current pandemic infection of the human respiratory system, which is caused by which caused by Sever Acute respiratory syndrome virus 2 (SARS-CoV-2). The ...infection was classified by World Health Organization (WHO) as a universal pandemic in February 2020; there have been 494.587.638 confirmed cases and 6.170.283 deaths. The present study investigated the molecular genetics of the Angiotensin Converting Enzyme 2 (
) gene in correlation to COVID-19 patients in the Kurdish population. Eighty-six individuals were clinically diagnosed with COVID-19 and control groups. After the genomic DNA extraction these participants the target 1, 2 and 8 exons of the ACE2 gene were amplified using the PCR technique, and then the Sanger sequencing technique was performed to analyze genetic variants of the
gene in 70 DNA samples of COVID-19 hospital patients at Emergency Hospital in Erbil city, Sarchnar Hospital in Sulaymaniyah city, Lalav Hospital in Duhok city and Wafa Hospital in Halabja city from Kurdistan Region of Iraq. The current study was designed into two groups control group and a patient group. The patient group was divided into two subgroups, severe and mild patients of different ages and genders. As a result, there were no mutations at the positions 1, 2 and 8 exons sequences, while single nucleotide polymorphisms (SNPs) were detected and identified three different types of mutation at intron position: twenty-six of c.12405 del T, two of c.12407 T>G, and two of c.12406 G>A in a total 86 participants. This result shows that genetic difference does not impact the COVID-19 infection severity among the Kurdish population regarding
gene polymorphism.
The prevalence of natural carriage and molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative staphylococci (MR-CoNS) isolates in a ...Jordanian community were investigated. The MRSA nasal carriage rate in 227 healthy volunteers was 7·5% and the majority (81%) of MRSA harboured the resistance element SCCmec type IVe and were of a novel spa type t9519 (76%); other significant spa gene types were t223 (14·7%) and t044 (5·9%). All MRSA isolates were susceptible to other classes of antibiotics, and tested positive for at least three virulence factor encoding genes, but only two harboured the pvl gene. MR-CoNS carriage was 54·2% and these isolates were characterized by single, double and untypable SCCmec elements, with Staphylococcus epidermidis SCCmec type IVa predominating. Of eight subjects with nasal co-colonization of MR-CoNS + MRSA, three shared SCCmec type IV in both groups of organisms. This is the first report of methicillin-resistant staphylococci carriage in a Jordanian community and its findings are important for epidemiological study and infection control measures of these organisms.
To evaluate the antimicrobial activities of aspirin, EDTA and an aspirin-EDTA (A-EDTA) combination against Pseudomonas aeruginosa, Escherichia coli and Candida albicans in planktonic and biofilm ...cultures. Minimal inhibitory concentrations (MIC) and minimal biocidal concentrations (MBC) were determined using twofold broth microdilution and viable counting methods, respectively. Aspirin's recorded MIC values ranged from 1·2 to 2·7 mg ml⁻¹. Checkerboard assay demonstrated a synergism in antimicrobial activity upon combination. Aspirin's minimal biofilm eradication concentration values (MBEC) against the established biofilms ranged between 1·35 and 3·83 mg ml⁻¹. A complete eradication of bacterial biofilms was achieved after a 4-h treatment with the A-EDTA combination. Both aspirin and EDTA possess broad-spectrum antimicrobial activity for both planktonic and biofilm cultures. Aspirin used at the MBEC for 24 h was successful in eradicating P. aeruginosa, E. coli and C. albicans biofilms established on abiotic surfaces. Moreover, the exposure to the A-EDTA combination (4 h) effected complete bacterial biofilm eradication. There is a continuous need for the discovery of new antimicrobial agents. Aspirin and EDTA are 'nonantibiotic drugs', the combination of which can be used successfully to treat and eradicate biofilms established on abiotic surfaces.
Open testicular biopsy histology and fine needle aspiration cytology (FNAC) are the most popular tests used to diagnose male infertility. This study aimed to assess the cytological characteristics of ...186 infertile males aged 24-63 with testicular FNAC. Furthermore, the existing relationship between males with severe oligospermia (sperm count: 5 million/ml) and azoospermia was investigated via both cytological and histological diagnosis methods. With a 1.5-inch and 25-gauge needle, the testis was aspirated from three locations (the upper, middle, and lower poles). Papanicolaou stain or Giemsa stain was used to make smears on albumenized slides, which were then dried in the air and stained. A biopsy of the testicles was performed there, preserved in Bouins solution, processed as usual, and stained with hematoxylin and eosin stain. According to our findings, 66.7% of patients had secondary maturation arrest, whereas 18.3% and 15.1% of them had hypospermatogenesis and Sertoli cell only (SCO). Results of the comparison showed that both procedures were very similar. According to biopsy histological examinations, only 3 (1.6%) of the 28 normal FNAC instances had hypospermatogenesis with lymphocyte infiltration. The majority of SCO patients were over 50 years old. These findings revealed that FNAC is more effective than testicular histology for the assessment of male infertility.
Purpose: Patients' awareness toward VTE and thromboprophylaxis is critical for medication adherence. This study aimed to evaluate the patient's awareness and perception towards VTE and its ...prophylaxis and to assess patient's satisfaction towards the information given by the medical staff. Participants and Methods: A cross-sectional survey was conducted among hospitalized patients who received VTE prophylaxis in public and private hospitals in Sana'a, Yemen. Besides sociodemographic variables, participants' awareness and perception of VTE and its prophylaxis were evaluated. Variables' association with VTE awareness were analyzed using univariable and multivariable logistic regression using SPSS. Results: A total of 396 of the hospitalized patients agreed to participate in the study, with 31% (n = 121) have ever heard about VTE. The multivariable logistic regression findings revealed that the participants who did not have a profession had OR = 17.182 (P < 0.001) of being unaware of VTE compared with those who had one. Participants who did not have a personal history of VTE had OR = 7.580 (P < 0.001) of being unaware of DVT/PE compared with the participants who had a personal history of VTE. Male participants had OR = 2.839 (P < 0.005) of being unaware of DVT/PE compared with female participants. Participants who were illiterate had OR = 2.832 (P < 0.022) of being unaware of DVT/PE compared with participants with a higher level of education. Conclusion: The study revealed lack of awareness and perception of VTE and its prophylaxis among hospitalized patients in Yemen. The patients who are unaware of the disease have wrong perception about their role in DVT prophylaxis. Patient's education must be considered in healthcare setting to improve patient's health outcomes. Keywords: anticoagulation, deep vein thrombosis, pulmonary embolism, patient's knowledge, patient's perception
In this study, we investigated the effect of sintering temperature and nano boehmite additions on the phase composition, densification, and mechanical properties of porous cordierite ceramics. ...Ceramic samples were sintered at temperatures ranging from 1200 to 1400°C. Carbon powder was used as a pore forming agent to improve the porosity of the ceramic structure. Nano boehmite and carbon additions significantly enhanced ceramic porosity and average pore size in sintered samples. The bulk density and apparent porosity of the sintered samples were found to be 0.96–1.53 g/cm3 and 42.3%–65.6%, respectively. Sintered samples had cold crushing strengths of 1.5–14.3 MPa. The microstructure obtained by scanning electron microscopy was used to measure average pore size in sintered samples and was found to be 41.93 µm for stoichiometric composition (SC), 67.72 µm for SC and nano boehmite, and 102.98 µm for SC, nano boehmite, and carbon. The microstructure of the sintered samples revealed that the crystallinity of the in situ formed phases increased with the increase in nano boehmite additions.
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