Prevalence of Intestinal Parasitic Infestations in Al-Anbar Province , West of Iraq.

Intestinal parasitic infestation still represents an economic and public health problem in the world particularly in the developing countries including the Middle East. To estimate the current prevalence of intestinal parasitic infection among people living in Al-Ramadi City/ West of Iraq. 1804 faecal samples were collected from males and females of different ages attending Al Gailani-Central Medical Laboratory, Al-Ramadi/Al-Anbar, from June 2006 to October 2009. One methods used were direct faecal microscopic examination and formol-ether concentration. The total infectivity rate by intestinal parasites was 19.7%. The overall infection rate by intestinal protozoa was significantly higher than intestinal helminth infection. E. histolytica was the most prevalent intestinal parasitic infection, whereas E. vermicularis was the predominant helminth. The frequency of the parasitic infestations was slightly higher among females (20.7%) than males (19.1%). A significantly higher prevalence of parasitic infections among younger age groups than the older age groups, since age group ≤5 years showed the highest infection rate (33.3%) when it was compared with other age groups (5.3%). Intestinal parasitic infestation was more prevalent among younger age groups. Screening for parasitic infestation is necessary as part of the general health care programme. Preference should be given to screening the younger age group to improve the standards of infant care

Biofilms Formation on Contact Lenses: Clinical and Bacteriological Study

Background: Biofilms can be defined as communities of microorganisms attached to a surface to prevent themselves from the environmental effects and cause infections.  A study on microbial contamination associated with contact lenses wearers was carried out on women in Ramadi city, some of them were asymptomatic and others were complaining of redness, tearing and itching. Objectives: Isolation and identification of microbial infection associated with contact lens wearers by examination of the storage case solution, studying of different factors that have effect on microbial infections among contact lenses wearers such as (age, wearing type, symptoms) and Performance of biofilm assay on the new contact lenses, Microtitre plate (MTP) and comparison with used contact lenses and the ability of biofilm formation among different isolates from storage case solution. Material and Methods: Eighty samples of solution were collected from women of different Sources who Contact lenses: Five used and two new contact lenses as well as Microtiter plate (MTP) were used as samples to observe biofilm formation in this study. Sample from twenty new storage solution bottles were used as a control sample Isolation and identification of microorganisms: Macroscopical examination, Culture and Biochemical tests. Microscopic examination were done. According to Yukinobu, el al., 2006. Results: The study was done during the period from April 2008 to Jan. 30th 2009. Samples were collected from (80) women distributed as follows: (housewife, pupil, student, staff and others). Their ages were ranging from 13 – 36 years. The most common age of contamination was found to be ranged between 19-24 years which accumulated for (55%) of all Eye' redness is found to be the most common symptom (26.25%)) complained by the sampled women of this study. Isolates of Pseudomonas aeruginosa, Staph. aureus, Staph. epidermidis, Liesteria and Klebsiella were obtained from the storage solutions of contact lenses. According to the optical density showed by Microtitre plate (MTP) Reader, Pseudomonas aeruginosa was the most common bacterial type associated with biofilm formation for the considered samples. Conclusion: Pseudomonas aeruginosa was the most common bacterial type associated with   Biofilm formations

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030