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Portraying Diabetic Foot Ulcers: Comparative Evaluation of Diabetic Foot Infections versus Diabetic Foot Ulcers

Advances in Infectious Diseases 2024年第2期14卷 297-309页

作者： Jamal Wadi Al Ramahi Leen Sharqawi sarah AL-Najafi Eman Awwad Haya M. Al-Obaidi Abdel Hafez Mohammad sara Nofal Dina Riyadh Al-Janabi ibrahim Zuhair Hamza Jamal Al-Masaeid Mohammed Al-Ithawi Dina Rasheed Bellal O. Al-Far Osama Al-Izi Qutaiba Al-Bustanji School of Medicine The University of Jordan Amman Jordan Department of the Internal Medicine The Specialty Hospital Amman Jordan Department of Pharmacy The Specialty Hospital Amman Jordan Department of the Medical Al Khalidi Hospital Amman Jordan Department of Pharmacy Jordan Hospital Amman Jordan Department of Internal Medicine Jordan Hospital Amman Jordan Department of General Surgery Jordan Hospital Amman Jordan

Background: Confusion often arises in caring for diabetic foot infections and ulcers, especially with antimicrobials;we aim to shed light on this entity and alert healthcare workers to its stewardship. Methods: Records were reviewed between February 2016 and September 2023. Data for patients diagnosed with diabetes and foot ulcers, infected or not, were examined following ICD 9 search terms. Records for patients were included if they were prediabetic/diabetic adults with foot ulcers, more than 18 years old, and on antidiabetic treatment. Patients were excluded if they insulin resistant, with normal HgbA1c levels, wheel-chair dependent, bed-bound, non-diabetic patients, diabetic patients who had vascular lower limb surgery earlier to ulcers, diabetic patients who had aortocoronary bypass, deep venous thrombosis within six months, malignancy, and severe clinical depression. A modified IWGDF/IDSA guidelines definitions for DFI and DFU was considered. Statistical analysis was done using R programming. Statistical methods were employed as appropriate, and a significant P-value was considered for P Results: Most characteristics were well balanced between DFI and DFU, on imaging osteomyelitis and tissue swelling were significantly more in DFI. Endovascular radiological procedures showed angiograms to be considerably more in DFI, while angioplasty was more in DFU, in addition to smoking. Bacteremia was uncommon, and swab cultures were mostly polymicrobial in both ulcers;no clear association with blood bacteria was detected with the polymicrobial growth, though few were concordant. Antimicrobials prescribed for both ulcers were not statistically different except for carbapenems, which were more in DFI (P Conclusion: Attention should be paid to best practices while caring for diabetic ulcers. These include swab culture interpretations, the use of antimicrobials, and plan management according to DFI or DFU to utilize either local care or combination with antimicrobials.

关键词： Diabetic Foot Ulcers Diabetic Limb Amputation Antimicrobials Stewardship Broad-Spectrum Antimicrobials in Diabetic Foot Ulcers

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Thermal, Morphological and Cytotoxicity Characterization of Hardwood Lignins Isolated by <i>In-Situ</i>Sodium Hydroxide-Sodium Bisulfate Method

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Natural Resources 2020年第10期11卷 427-438页

作者： Ahmed Geies Mohamed Abdelazim Ahmed Mahmoud Sayed sara ibrahim Chemistry Department Faculty of science Assiut University Assiut Egypt Chemical and Biotechnological Laboratories Sugar Industry Technology Research Institute Assiut University Assiut Egypt

In the present work, lignin is isolated from three different agro-industrial waste, sweet sorghum, rice straw and sugarcane bagasse using in-situ sodium hydroxide-sodium bisulfate methodology. Characterization was performed using fourier transform infrared analysis (FTIR), scan electron microscopy (SEM), thermo gravimetric analysis (TGA). The SEM micrographs showed sponge-like structure except for sugarcane bagasse lignin reveals rock-like structure. The FTIR indicates the presence of hydroxyl, carbonyl and methoxyl groups in the lignin structure. TGA thermograms were relatively same and sugarcane bagasse lignin was found the most thermally stable up to 201˚C as compared to both of soda and kraft sugarcane bagasse lignin and its maximal temperature degradation rate DTGmax was found at 494˚C while 450˚C, 464˚C in addition to thermal stabilities up to 173˚C and 180˚C for sweet sorghum and rice straw lignins respectively. All lignins exhibited low percentage of bio-char less than 10% remained unvalotilized at the end of the thermogravimetric analysis at 800˚C in nitrogen atmosphere, revealing

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Sodium-glucose co-transporter 2 inhibitors induced euglycemic diabetic ketoacidosis within four days of initiation

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World Journal of Diabetes 2022年第3期13卷 272-274页

作者： Almurtada Razok Fateen Ata sara Mohamed ibrahim Ahmed Dabia Hamad S H Al Mohanadi Department of Internal Medicine Hamad Medical CorporationDoha 3050Qatar Department of Endocrinology Hamad Medical CorporationDoha 3050Qatar

Euglycemic diabetic ketoacidosis(EDKA)is a well-known complication of sodium-glucose co-transporter 2 inhibitors,and many cases with variable onset following the initiation of these agents are reported before,with a median onset of approximately 2 wk.This letter discusses a 45-year-old lady who initially presented with ischemic stroke but developed EDKA 4 d after starting empagliflozin,a rare occurrence.The patient had severe metabolic acidosis that necessitated admission into the intensive care unit.Prompt discontinuation of empagliflozin and DKA management resulted in clinical recovery.

关键词： Euglycemic diabetic ketoacidosis Sodium-glucose co-transporter 2 inhibitors Type 2 diabetes mellitus Empagliflozin

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Evaluation of On-Line MPPT Algorithms for PV-Based Battery Storage Systems

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Computers, Materials & Continua 2022年第11期73卷 3595-3611页

作者： Belqasem Aljafari Eydhah Almatrafi Sudhakar Babu Thanikanti sara A.ibrahim Mohamed A.Enany Marwa M.Ahmed Electrical Engineering Department College of EngineeringNajran UniversityNajran11001Saudi Arabia Mechanical Engineering Department College of Engineering-RabighKing Abdulaziz UniversityJeddahSaudi Arabia K.A.CARE Energy Research and Innovation Center King Abdulaziz UniversityJeddah21589Saudi Arabia Center of Excellence in Desalination Technology King Abdulaziz UniversityJeddahSaudi Arabia Department of Electrical and Electronics Engineering Chaitanya Bharathi Institute of TechnologyHyderabad500075India Electrical Power and Machines Department Faculty of EngineeringZagazig UniversityZagazig44519Egypt Electrical Engineering Department Faculty of EngineeringKing Abdul-Aziz UniversityJeddah80204Saudi Arabia

This paper presents a novel Simulink models with an evaluation study of more widely used On-Line Maximum Power Point tracking(MPPT)techniques for Photo-Voltaic based Battery Storage Systems(PV-BSS).To have a full comparative study in terms of the dynamic response,battery state of charge(SOC),and oscillations around the Maximum Power Point(MPP)of the PV-BSS to variations in climate conditions,these techniques are simulated in Matlab/Simulink.The introduced methodologies are classified into two types;the first type is conventional hill-climbing techniques which are based on instantaneous PV data measurements such as Perturb&Observe and Incremental Conductance techniques.The second type is a novel proposed methodology is based on using solar irradiance and cell temperature measurements with pre-build Adaptive Neuro-Fuzzy Inference System(ANFIS)model to predict DC–DC converter optimum duty cycle to track MPP.Then evaluation study is introduced for conventional and proposed On-Line MPPT techniques.This comparative study can be useful in specifying the appropriateness of the MPPT techniques for PV-BSS.Also the introduced model can be used as a valued reference model for future research related to Soft Computing(SC)MPPT techniques.A significant improvement of SOC is achieved by the proposed model and methodology with high accuracy and lower oscillations.

关键词： Photo-voltaic based battery storage systems adaptive neuro-fuzzy inference system maximum power point tracking perturb&observe technique incremental conductance technique state of charge

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Geospatial susceptibility mapping of earthquake-induced landslides in Nuweiba area, Gulf of Aqaba, Egypt

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Journal of Mountain Science 2016年第7期13卷 1286-1303页

作者： sara ABUZIED Samia ibrahim Mona KAISER Tarek Saleem Center for Spatial Analysis University of Oklahoma Geology Departments Faculty of Science Suez Canal University

Earthquake induced landslides are one of the most severe geo-environmental hazards that cause enormous damage to infrastructure, property, and loss of life in Nuweiba area. This study developed a model for mapping the earthquake-induced landslide susceptibility in Nuweiba area in Egypt with considerations of geological, geomorphological, topographical, and seismological factors. An integrated approach of remote sensing and GIS technologies were applied for that target. Several data sources including Terra SAR-X and SPOT 5 satellite imagery, topographic maps, field data, and other geospatial resources were used to model landslide susceptibility. These data were used specifically to produce important thematic layers contributing to landslide occurrences in the region. A rating scheme was developed to assign ranks for the thematic layers and weights for their classes based on their contribution in landslide susceptibility. The ranks and weights were defined based on the knowledge from field survey and authors experiences related to the study area. The landslide susceptibility map delineates the hazard zones to three relative classes of susceptibility: high, moderate, and low. Therefore, the current approach provides a way to assess landslide hazards and serves for geo-hazard planning and prediction in Nuweiba area.

关键词：资源空间模型地震滑坡敏感性埃及环境地质灾害基础设施山体滑坡财产损失

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Genetics of congenital and infantile nephrotic syndrome

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World Journal of Pediatrics 2019年第2期15卷 198-203页

作者： sara Nawfal Sharief Nada Abdullatif Hefni Walaa Ali Alzahrani Iman ibrahim Nazer Marwa Abdullah Bayazeed Khalid A.Alhasan Osama Y.Safdar Sherif M.El-Desoky Jameela Abdulaziz Kari King Abdulaziz University JeddahKingdom of Saudi Arabia College of Medicine Pediatric DepartmentKing Saud UniversityRiyadhKingdom of Saudi Arabia Department of Pediatrics Faculty of MedicinePediatric Nephrology Center of ExcellenceKing Abdulaziz UniversityPO Box 80215Jeddah 21589Kingdom of Saudi Arabia

Background Congenital and infantile nephrotic syndrome (CNS and INS) are rare inherited defects in glomerular filtration involving a variety of gene mutations.This study aimed to analyze all genetic mutations associated with congenital and infantile nephrotic syndrome treated at our institution.We also discussed our different approach secondary to culture and resources.Methods A retrospective single-center study of all children diagnosed as NS before the age of l year over a duration of over one decade.Results Twenty-nine children (12 boys) were included in the study.Their median age (range) was 2.4 (0.1-12) months (20 CNS and 9 INS).Consanguinity was present in 90% of children.The genetic analysis' results were only available for 20 children.An underlying causative homozygous mutation was detected in 18 children (90%):NPHS1 (9),NPHS2(2),LAMB2(3),PLCE1(1),WT1(1),and ITSN1 novel mutation (2).One child had heterozygous mutation of NPHS2 and another child had heterozygous mutation of NPHS1 which could not explain the disease.All CNS cases were all managed with intermittent intravenous albumin infusion,ACEi,diuretics,and indomethacin.None of the children were managed by nephrectomy followed by peritoneal dialysis (PD) because of limited resources.Only one child achieved partial remission,while 15 children died at a median (range) age of 5.8 (1.25-29) months.The remaining 14 children were followed up for an average of 36 (3.9-120) months.Three children progressed to end-stage kidney disease and PD was performed in only two children.Conclusions NPHS1 is the main underlying cause of CNS and INS in our study population.CNS and INS were associated with high morbidity and mortality.

关键词： Congenital nephrotic Infantile nephrotic Genetics Outcome

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Nurses’ Knowledge, Attitude and Practice of Oral Care for Intensive Care Unit Patients

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Open Journal of Stomatology 2015年第7期5卷 179-186页

作者： sara Mohamed ibrahim Amal Mohamed Mudawi Osama Omer Department of Dental Public Health Faculty of Dentistry Al-Neelain University Khartoum Sudan Department of Prevention and Community Dentistry Faculty of Dentistry University of Khartoum Khartoum Sudan Department of Restorative Dentistry Dublin Dental University Hospital University of Dublin Dublin Ireland

The aim of this study was to describe the intensive care unit (ICU) nurses’ knowledge, attitude, and practice of mouth care for their patients. This is a cross sectional hospital based study. A total of 154 ICU nurses were randomly selected from seven governmental hospitals in Khartoum state and were invited to take part in this study. 97.4% of ICU nurses had high knowledge of the importance of mouth care for ICU patients and similarly for the priority of mouth care. However, only 20% of nurses were found to apply good practice. 64.5% of the nurses received training in mouth care provision, and (81%) indicated that further training would be beneficial. The oral care practice of ICU nurses ranged between average among 57% and poor among 23%. The study highlighted the need for setting of ICU protocols and adoption of advanced training for ICU nurses.

关键词： Oral Health Intensive Care Unit Nurses’ Knowledge

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Assessing Drug Use Indicators in Health Insurance Facilities, Gezira State, Sudan, 2017-2018

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Pharmacology & Pharmacy 2021年第10期12卷 237-246页

作者： sara Abdelrahman Ahmed Elnazeer ibrahim Hamedelniel Abubakr Khidir Yousif Medical Service Directorate National Health Insurance Fund Gezira Sudan Department of Pharmaceutics College of Pharmacy Omdurman Islamic University Omdurman Sudan MPH MHPE National Health Insurance Fund Gezira Sudan

Background: Inappropriate use of medicines is a global concern with serious consequences related to prescribing, dispensing, and use. WHO estimated that 50% of medicines are not used correctly on their journey from the facility to home. Objective: To assess medicines use using WHO drug core indicators regarding prescribing, patient, and facilities. Setting: Outpatients, Health centers in Wadmadani locality (Urban area) in Gezira State, Sudan. Method: A cross-sectional, prospective, analytical study was conducted in 30 health centers and 60 patients from each center were selected using a simple random sampling technique. WHO indicators form was used to collect data containing different variables. T-test at a level of confidence of 95% was used to test differences between indicators. Statistical Package for Social Science (SPSS) was used for data analysis. Results: The main prescribing indicators were 2.5 ± 0.6 for drugs per encounter, 44.1% ± 14.2%. Generic 54 ± 18.0 antibiotics, 12.0% ± 9.3% injectable, and 95.2% ± 11.5% of drugs were prescribed according to the NHIF-EML. The main patient’s indicators were, 2.9 ± 0.8 minutes for consultation time, 99.5 ± 36.8 seconds for dispensing time, and 72.5% ± 16.0% for medicines actually dispensed, 49.0% ± 18.0% for medicines adequately labeled, and 22.5% ± 7.3% of the patient’s knowledge about the correct dose. The Facilit

关键词： Assessing Drug Use Indicators National Health Insurance Fund Gezira Sudan

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Reversibility of minimal hepatic encephalopathy following liver transplantation in Egyptian cirrhotic patients

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World Journal of Hepatology 2016年第30期8卷 1279-1286页

作者： Mahmoud A Osman Moataz M Sayed Khaled A Mansour Shereen A Saleh Wesam A ibrahim sara M Abdelhakam Mohamed Bahaa Wael A Yousry Hosam S Elbaz Reginia N Mikhail Azza M Hassan Ehab H Elsayed Dalia A Mahmoud Department of Internal Medicine Hepatology and Gastroenterology Faculty of Medicine Ain Shams University Department of Tropical Medicine Faculty of Medicine Ain Shams University Department of Hepatobiliary Surgery Faculty of Medicine Ain Shams University Department of Community Environmental and Occupational Medicine Faculty of Medicine Ain Shams University Department of Internal Medicine Hepatology and Gastroenterology National Research Center Department of Neuropsychiatry Faculty of Medicine Ain Shams University

AIM To evaluate the reversibility of minimal hepatic encephalopathy(MHE) following liver transplantation(LT) in Egyptian cirrhotic patients. METHODS This prospective study included twenty patients with biopsy-proven liver cirrhosis listed for LT and twenty ageand sex-matched healthy control subjects. All underwent neuro-psychiatric examination, laboratory investigations, radiological studies and psychometric tests including trail making test A(TMT A), TMT B, digit symbol test and serial dotting test. The psychometric hepatic encephalopathy score(PHES) was calculated for patients to diagnose MHE. Psychometric tests were repeated six months following LT in the cirrhotic patient group. RESULTS Before LT, psychometric tests showed highly significant deficits in cirrhotic patients in comparison to controls(P < 0.001). There was a statistically significant improvement in test values in the patient group after LT; however, their values were still significantly worse than those of the controls(P < 0.001). The PHES detected MHE in 16 patients(80%) before LT with a median value of -7 ± 3.5. The median PHES value was significantly improved following LT, reaching-4.5 ± 5(P < 0.001), and the number of patients with MHE decreased to 11(55%). The pre-transplant model for end-stage liver disease(MELD) score ≥ 15 was significantly related to the presence of post-transplant MHE(P = 0.005). More patients in whom reversal of MHE was observed had a pre-transplant MELD score < 15.CONCLUSION Reversal of MHE in cirrhotic patients could be achieved by LT, especially in those with a MELD score < 15.

关键词：肝移植为结束阶段肝疾病 20 当模特儿 Psychometric 测试最小的肝的 encephalopathy 肝硬化

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Hepatitis C virus and neurological damage

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World Journal of Hepatology 2016年第12期8卷 545-556页

作者： shilu mathew muhammed faheem sara m ibrahim waqas iqbal bisma rauff kaneez fatima ishtiaq qadri center of excellence in genomic medicine research king abdulaziz universityjeddah 21589saudi arabia department of biosciences faculty of sciencescomsats institute of information technologyIslamabad 45550Pakistan department of biochemistry king abdulaziz universityjeddah 21589saudi arabia westmead millennium institute for medical research university of sydneySydneyNSW 2006Australia iq institute of infection and immunity Lahore 54000Pakistan king fahd medical research center king abdulaziz university Jeddah 21589 Saudi Arabia

Chronic hepatitis C virus(HCV) infection exhibits a wide range of extrahepatic complications, affecting various organs in the human body. Numerous HCV patients suffer neurological manifestations, ranging from cognitive impairment to peripheral neuropathy. Overexpression of the host immune response leads to the production of immune complexes, cryoglobulins, as well as autoantibodies, which is a major pathogenic mechanism responsible for nervous system dysfunction. Alternatively circulating inflammatory cytokines and chemokines and HCV replication in neurons is another factor that severely affects the nervous system. Furthermore, HCV infection causes both sensory and motor peripheral neuropathy in the mixed cryoglobulinemia as well as known as an important risk aspect for stroke. These extrahepatic manifestations are the reason behind underlying hepatic encephalopathy and chronic liver disease. The brain is an apt location for HCV replication, where the HCV virus may directly wield neurotoxicity. Other mechanisms that takes place by chronic HCV infection due the pathogenesis of neuropsychiatric disorders includes derangement of metabolic pathways of infected cells, autoimmune disorders, systemic or cerebral inflammation and alterations in neurotransmitter circuits. HCV and its pathogenic role is suggested by enhancement of psychiatric and neurological symptoms in patients attaining a sustained virologic response followed by treatment with interferon; however, further studies are required to fully assess the impact of HCV infection and its specific antiviral targets associated with neuropsychiatric disorders.

关键词： Hepatitis C virus Neuro disorders Blood brain barrier Nervous system Inflammation

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