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Variation in Progesterone Levels and Urinary Tract Infections in Pregnant Women Attending moi teaching and referral hospital, Eldoret, Kenya

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Open Journal of Medical Microbiology 2023年第1期13卷 125-135页

作者： Anne Wanjiku Lizzy Mwamburi Moses Ngeiywa Andrew Obala moi teaching and referral hospital Laboratory Department Eldoret Kenya Department of Biological Sciences University of Eldoret Eldoret Kenya Department of Microbiology and Parasitology Moi University Eldoret Kenya

Background and Aims: Urinary tract infections (UTIs) are common among pregnant women and major predisposing factors for pyelonephritis linked to obstetrical complications including preterm labour and low infants’ birth weights. This study sought to determine the relationship(s) between pregnancy trimesters, UTIs and changes in progesterone levels among pregnant women. Materials and Methods: The study was conducted in 2016 at moi teaching and referral hospital (MTRH) antenatal clinic which is a referral facility that attends to patients from most Counties in western region of Kenya. A cross-sectional study design was used to collect blood and urine specimens from 78 participants. Blood was used to determine progesterone levels using ELISA technique and urine cultures with bacterial colony counts ≥ 105 were appropriately identified to species level. Trimester periods and participants’ demographic information were obtained using a structured questionnaire. Results: Culture results showed that the most abundant bacterial species isolated in urine from the pregnant women was Escherechia coli (63.7%). The more affected age-group was women between 30 - 39 years during trimester three, suggesting that bacterial colonization of genital track occurred more frequently in older compared to the younger women. There was an exponential increase in progesterone levels among the pregnant women during trimester three compared to other trimesters, although these increases occurred independent of age. However, high levels of progesterone among pregnant women in third trimester corresponded with increased number of E. coli causing UTI. Conclusion: The results showed that progesterone levels increase with trimester and the most prevalent bacteria associated with this was E. coli even though age and increase in progesterone levels had no significant impact on E. coli infection.

关键词： Urinary Tract Infection Progesterone Trimester Escherichia coli

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Prevalence and Anti-Microbial Susceptibility of Methicillin Resistant Staphylococcus aureus at moi teaching and referral hospital Eldoret

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Open Journal of Medical Microbiology 2016年第1期6卷 9-16页

作者： Christine Akoru Robert T. Kuremu Samson K. Ndege A. Obala James W. Smith Marilyn Bartlett moi teaching and referral hospital Microbiology Department Eldoret Kenya moi University School of Medicine Eldoret Kenya moi University School of Public Health Eldoret Kenya Indiana University School of Medicine Indianapolis IN USA

Background: Methicillin-resistant Staphylococcus aureus (MRSA) are pathogens that have major negative impact in all aspects of patient care and are increasingly being recognized as troublesome pathogens in the community. The MRSA are multi-drug resistant bacteria responsible for higher morbidity, mortality and cost of treatment in the affected patients. Research on MRSA antimicrobial susceptibility and resistance in developing countries is limited;hence accurate burden is not certain. Objective: To determine the prevalence and susceptibility pattern of MRSA in S. aureus isolates from patients treated in various units at moi teaching and referral hospital. Study Design: Cross-sectional design was used to conduct the study. Methods and Materials: Staphylococcus aureus stored isolates from patients at various units at moi teaching and referral hospital (MTRH) were identified by laboratory conventional methods. Methicillin resistant Staphylococcus aureus was determined using cefoxitin and oxacillin, discs and confirmed by Penicillin Binding Protein (PBP2a’) latex agglutination test. Susceptibility testing was performed according to the Clinical Laboratory Standards Institute procedures. Control strains used were: ATCC 43300 for Methicillin resistant S. aureus (MRSA) strains and ATCC 29213 for methicillin susceptible S. aureus (MSSA) strains. Nine anti-microbials (Erythromycin, Gentamycin, Tetracycline, Vancomycin, Rifampin, Linezolid, Ciprofloxacin, Clindamycin and Fucidicacid) were used to test the anti-microbial susceptibility patterns. Control organisms were run along with the isolates for quality Assurance. The data was analyzed using STATA version 11. Categorical variables were summarized as frequencies and the corresponding percentages. Results were presented using tables and graphs. Results: A total of 107 isolates of S. aureus were obtained, of which 39 (37%) were MRSA. Most of the MRSA, 13 (33%) and 7 (17%), were found in pus and tracheal aspirate samples respe

关键词： MRSA High Burden Specimens Wards with High Burden of Isolates and Drug Susceptibility

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Diagnosis and management of malaria in the intensive care unit

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Journal of Intensive Medicine 2024年第1期4卷 3-15页

作者： George Akafity Nicholas Kumi Joyce Ashong Department of Research Monitoringand EvaluationCape Coast Teaching HospitalCape CoastGhana Intensive Care Unit Department of Critical Care and AnesthesiaCape Coast Teaching HospitalCape Coast Department of Paediatrics and Child Health Cape Coast Teaching HospitalCape CoastGhana

Malaria is responsible for approximately three-quarters of a million deaths in humans globally each *** of the morbidity and mortality reported are from Sub-Saharan Africa and Asia,where the disease is *** non-endemic areas,malaria is the most common cause of imported infection and is associated with significant mortality despite recent advancements and investments in elimination *** malaria often requires intensive care unit admission and can be complicated by cerebral malaria,respiratory distress,acute kidney injury,bleeding complications,and *** care management includes prompt diagnosis and early initiation of effective antimalarial therapy,recognition of complications,and appropriate supportive ***,the lack of diagnostic capacities due to limited advances in equipment,personnel,and infrastructure presents a challenge to the effective diagnosis and management of *** article reviews the clinical classification,diagnosis,and management of malaria as relevant to critical care clinicians,highlighting the role of diagnostic capacity,treatment options,and supportive care.

关键词： Malaria Intensive care unit Severe malaria Antimicrobial resistance Antimalarials Artemisinin-based combination therapy

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Is tumor necrosis factor-α monoclonal therapy with proactive therapeutic drug monitoring optimized for inflammatory bowel disease? Network meta-analysis

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World Journal of Gastrointestinal Surgery 2024年第2期16卷 571-584页

作者： Fang-Yuan Zheng Kai-Si Yang Wen-Cheng Min Xin-Zhu Li Yu Xing Shuai Wang Ying-Shi Zhang Qing-Chun Zhao teaching hospital of Shenyang Pharmaceutical University General Hospital of Northern Theater CommandShenyang 110016Liaoning ProvinceChina

BACKGROUND The efficacy and safety of anti-tumor necrosis factor-α(TNF-α)monoclonal antibody therapy[adalimumab(ADA)and infliximab(IFX)]with therapeutic drug monitoring(TDM),which has been proposed for inflammatory bowel disease(IBD)patients,are still *** To determine the efficacy and safety of anti-TNF-αmonoclonal antibody therapy with proactive TDM in patients with IBD and to determine which subtype of IBD patients is most suitable for proactive TDM *** As of July 2023,we searched for randomized controlled trials(RCTs)and observa-tional studies in PubMed,Embase,and the Cochrane Library to compare anti-TNF-αmonoclonal antibody therapy with proactive TDM with therapy with reactive TDM or empiric *** and network meta-analyses were used to determine the IBD patient subtype that achieved clinical remission and to determine the need for *** This systematic review and meta-analysis yielded 13 studies after exclusion,and the baseline indicators were *** found a significant increase in the number of patients who achieved clinical remission in the ADA[odds ratio(OR)=1.416,95%confidence interval(CI):1.196-1.676]and RCT(OR=1.393,95%CI:1.182-1.641)subgroups and a significant decrease in the number of patients who needed surgery in the proactive vs reactive(OR=0.237,95%CI:0.101-0.558)and IFX+ADA(OR=0.137,95%CI:0.032-0.588)subgroups,and the overall risk of adverse events was reduced(OR=0.579,95%CI:0.391-0.858)according to the pairwise ***,the network meta-analysis results suggested that patients with IBD treated with ADA(OR=1.39,95%CI:1.19-1.63)were more likely to undergo TDM,especially in comparison with patients with reactive TDM(OR=1.38,95%CI:1.07-1.77).CONCLUSION Proactive TDM is more suitable for IBD patients treated with ADA and has obvious advantages over reactive *** recommend proactive TDM in IBD patients who are treated with ADA.

关键词： Inflammatory bowel disease Therapeutic drug monitoring Adalimumab Infliximab Network meta-analysis

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Optimized sequential therapy vs 10- and 14-d concomitant therapy for eradicating Helicobacter pylori: A randomized clinical trial

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World Journal of Gastroenterology 2024年第6期30卷 556-564页

作者： Hassan Seddik Jihane Benass Sanaa Berrag Asmae Sair Reda Berraida Hanae Boutallaka Department of Gastroenterology II Mohammed V Military Teaching Hospital of RabatRabat 10100Morocco Department of Gastroenterology Mohammed V University in RabatRabat 10100Morocco Department of Gastroenterology I Mohammed V Military Teaching Hospital of RabatRabat 10100Morocco

BACKGROUND A cure for Helicobacter pylori(***)remains a problem of global *** prevalence of antimicrobial resistance is widely rising and becoming a challenging issue *** sequential therapy seems to be one of the most attractive strategies in terms of efficacy,tolerability and *** most common sequential therapy consists of a dual therapy[proton-pump inhibitors(PPIs)and amoxicillin]for the first period(5 to 7 d),followed by a triple therapy for the second period(PPI,clarithromycin and metronidazole).PPIs play a key role in maintaining a gastric pH at a level that allows an optimal efficacy of antibiotics,hence the idea of using new generation *** open-label prospective study randomized 328 patients with confirmed *** infection into three groups(1:1:1):The first group received quadruple therapy consisting of twice-daily(bid)omeprazole 20 mg,amoxicillin 1 g,clarith-romycin 500 mg and metronidazole 500 mg for 10 d(QT-10),the second group received a 14 d quadruple therapy following the same regimen(QT-14),and the third group received an optimized sequential therapy consisting of bid rabe-prazole 20 mg plus amoxicillin 1 g for 7 d,followed by bid rabeprazole 20 mg,clarithromycin 500 mg and metronidazole 500 mg for the next 7 d(OST-14).AEs were recorded throughout the study,and the *** eradication rate was determined 4 to 6 wk after the end of treatment,using the 13C urea breath *** In the intention-to-treat and per-protocol analysis,the eradication rate was higher in the OST-14 group compared to the QT-10 group:(93.5%,85.5%P=0.04)and(96.2%,89.5%P=0.03)***,there was no statist-ically significant difference in eradication rates between the OST-14 and QT-14 groups:(93.5%,91.8%P=0.34)and(96.2%,94.4%P=0.35),*** overall incidence of AEs was significantly lower in the OST-14 group(P=0.01).Furthermore,OST-14 was the most cost-effective among the three *** The optimized 14-

关键词： Helicobacter pylori Quadruple therapy Sequential Proton-pump inhibitor Optimization

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Liver transplantation as an alternative for the treatment of non-resectable liver colorectal cancer: Advancing the therapeutic algorithm

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Hepatobiliary & Pancreatic Diseases International 2024年第2期23卷 154-159页

作者： Badi Rawashdeh Richard Bell Abdul Hakeem Raj Prasad Division of Transplant Surgery Department of General SurgeryMedical College of WisconsinMilwaukeeWI53226USA Leeds teaching hospital LeedsUK

Colorectal cancer is a leading cause of cancerrelated mortality,with nearly half of the affected patients developing liver *** three decades,liver resection(LR)has been the primary curative strategy,yet its applicability is limited to about 20%of *** transplantation(LT)for unresectable metastases was attempted unsuccessfully in the 1990s,with high rates of perioperative death and *** is now more interest in this strategy due to improvements in systemic therapies and surgical techniques.A significant study conducted by the Oslo group showed that patients receiving liver transplants had a 60%chance of survival after five *** better results have been achieved by using advanced imaging for risk stratification and further refining selection criteria,especially in the Norvegian SECA *** review carefully charts the development and history of LT as a treatment option for colorectal cancer liver *** revolutionary path from the early days of exploratory surgery to the current situation of cautious optimism is traced,highlighting the critical clinical developments and improved patient selection standards that have made LT a potentially curative treatment for such challenging very well selected cases.

关键词： Liver transplantation Colorectal cancer liver metastases Non-resectable liver metastases

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Circ_0003855 involvement of esophageal cancer progression through miR-622/FLOT1

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Oncology Research 2024年第5期32卷 925-931页

作者： JINGJING TIAN XIBAO HU XINRONG ZHANG Department of Gastroenterology Tianjin Nankai HospitalTianjin300100China Department of Digestive Medicine First Teaching Hospital of Tianjin University of Traditional Chinese MedicineTianjin300100China

To confirm the relationship between Circ_0003855 and EC,we purchased the Human esophageal carcinoma cell line Eca109 and normal human esophageal epithelial cells HEEC,and the expression levels of Circ_0003855,miR-622,and FLOT1 were *** results show that Circ_0003855 and FLOT1 were highly expressed in Eca109 cells,while miR-622 was lowly expressed(p0.05).Synthesizing the results of these experiments above,we believe that interfering with the expression of Circ_0003855 can inhibit the activity of EC cells,and its mechanism is related to miR-622 and FLOT1.

关键词： Circ_0003855 miR-622 FLOT1 Esophageal cancer Cell proliferation

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P7C3-A20 treats traumatic brain injury in rats by inhibiting excessive autophagy and apoptosis

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Neural Regeneration Research 2024年第5期19卷 1078-1083页

作者： Zhiqing Yang Zhenchao Wang Xiaoqi Deng Lingxin Zhu Zhaomeng Song Changyu Cao Xinran Li School of Life Science and Engineering Foshan UniversityFoshanGuangdong ProvinceChina Foshan University Veterinary teaching hospital FoshanGuangdong ProvinceChina

Traumatic brain injury is a severe health problem leading to autophagy and apoptosis in the brain.3,6-Dibromo-beta-fluoro-N-(3-methoxyphenyl)-9H-carbazole-9-propanamine(P7C3-A20)can be neuroprotective in various diseases,including ischemic stroke and neurodegenerative ***,whether P7C3-A20 has a therapeutic effect on traumatic brain injury and its possible molecular mechanisms are ***,in the present study,we investigated the therapeutic effects of P7C3-A20 on traumatic brain injury and explored the putative underlying molecular *** established a traumatic brain injury rat model using a modified weight drop method.P7C3-A20 or vehicle was injected intraperitoneally after traumatic brain *** neurological deficits were found in rats after traumatic brain injury,with deterioration in balance,walking function,and learning ***,hematoxylin and eosin staining showed significant neuronal cell damage,while terminal deoxynucleotidyl transferase mediated dUTP nick end labeling staining indicated a high rate of *** presence of autolysosomes was observed using transmission electron microscope.P7C3-A20 treatment reversed these pathological *** blotting showed that P7C3-A20 treatment reduced microtubule-associated protein 1 light chain 3-Ⅱ(LC3-Ⅱ)autophagy protein,apoptosis-related proteins(namely,Bcl-2/adenovirus E1B 19-kDa-interacting protein 3[BNIP3],and Bcl-2 associated x protein[Bax]),and elevated ubiquitin-binding protein p62(p62)autophagy protein ***,P7C3-A20 can treat traumatic brain injury in rats by inhibiting excessive autophagy and apoptosis.

关键词： apoptosis autophagy cortex hippocampus motor function P7C3-A20 traumatic brain injury

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Does dutasteride reduce the bleeding in transurethral resection of the prostate in patients on antiplatelet drugs?

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Current Urology 2024年第3期18卷 194-198页

作者： Ahmed M.Rammah Alaa Meshref Ebram Soliman Islam Nasser Abd Elaziz Enmar Habib Ahmed Yehia Abdelaziz Ahmed H.Abozamel Department of Urology Kasr Alainy HospitalFaculty of MedicineCairo UniversityCairoEgypt El Sahel teaching hospital CairoEgypt

Background The aim of this study was to assess the effect of a 4-week dutasteride treatment on reducing the intraoperative and postoperative bleeding,as well as the amount and duration of irrigation required to clear the urine after transurethral resection of the prostate(TURP)≥50 g in men receiving the antiplatelet drug(APD).Materials and methods This double-blind randomized clinical trial included patients with a prostate size≥50 g who were indicated for TURP and were already receiving *** study was conducted in the Urology Department of Cairo University over a 12-month *** preoperative laboratory investigations were performed in all ***,baseline prostate size,serum prostate-specific antigen level,and International Prostate Symptom Score were *** patients were randomly divided into 2 equal groups(groups A and B).Group A,the dutasteride group,received dutasteride(0.5 mg)once daily for 4 *** B,the placebo group,received a placebo capsule once daily for 4 *** groups underwent bipolar *** patients were excluded from the study;9 patients from group A and 6 patients from group B,either due to drug intolerability or loss *** The mean blood loss was insignificant between the 2 groups immediately after and 24 hours after surgery(Δhemoglobin:1.41±0.63 g/dL vs.1.48±0.54 g/dL,2.12±0.70 g/dL vs.2.31±0.78 g/dL,respectively,p=0.631,p=0.333;Δhematocrit:2.97%±1.51%vs.3.16%±1.36%,4.96%±1.87%vs.5.73%±4.39%,respectively,p=0.610,p=0.380).However,there were significant differences in duration of indwelling urethral catheter(5.10±0.55 days vs.5.80±1.79 days,p=0.048),duration of bladder irrigation(13.60±2.85 hours vs.16.33±6.62 hours,p=0.044),and the amount of saline used for bladder irrigation(11.03±2.30 L vs.13.87±6.13 L,p=0.046)between group A and group *** Treatment with dutasteride for 4 weeks before TURP in men receiving APD did not significantly reduce intraoperative or postoperativ

关键词： Dutasteride Transurethral resection of the prostate Postprostatectomy bleeding Antiplatelet drugs

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Association of Cytokines with Clinical Indicators in Patients with Drug-Induced Liver Injury

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Biomedical and Environmental Sciences 2024年第5期37卷 494-502页

作者： CAO Wei Hua JIANG Ting Ting SHEN Ge DENG Wen WANG Shi Yu ZHANG Zi Yu LI Xin Xin LU Yao ZHANG Lu LIU Ru Yu CHANG Min WU Shu Ling GAO Yuan Jiao HAO Hong Xiao CHEN Xiao Xue HU Lei Ping XU Meng Jiao YI Wei XIE Yao LI Ming Hui Department of Hepatology Division 2 Beijing Ditan HospitalCapital Medical UniversityBeijing 100015China Department of Hepatology Division 2 Peking University Ditan Teaching HospitalBeijing 100015China Department of Gynecology and Obstetrics Beijing Ditan HospitalCapital Medical UniversityBeijing 100015China

Objective To explore characteristics of clinical parameters and cytokines in patients with drug-induced liver injury(DILI)caused by different drugs and their correlation with clinical *** The study was conducted on patients who were up to Review of Uncertainties in Confidence Assessment for Medical Tests(RUCAM)scoring criteria and clinically diagnosed with *** on Chinese herbal medicine,cardiovascular drugs,non-steroidal anti-inflammatory drugs(NSAIDs),antiinfective drugs,and other drugs,patients were divided into five *** were measured by Luminex *** characteristics of clinical biochemical indicators and cytokines in DILI patients and their correlation were *** 73 patients were *** among five groups was statistically different(P=0.032).Alanine aminotransferase(ALT)(P=0.033)and aspartate aminotransferase(AST)(P=0.007)in NSAIDs group were higher than those in chinese herbal medicine ***-6(IL-6)and tumor necrosis factor alpha(TNF-α)in patients with Chinese herbal medicine(IL-6:P<0.001;TNF-α:P<0.001)and cardiovascular medicine(IL-6:P=0.020;TNF-α:P=0.001)were lower than those in NSAIDs *** was a positive correlation between ALT(r=0.697,P=0.025),AST(r=0.721,P=0.019),and IL-6 in NSAIDs *** Older age may be more prone to *** with NSAIDs have more severe liver damage in early stages of DILI,TNF-αand IL-6 may partake the inflammatory process of DILI.

关键词： Drug-induced liver injury Cytokines Non-steroidal anti-inflammatory drugs Inflammation

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