1^{1}H magnetic resonance spectroscopy in the differentiation between low- and high-grade cervical carcinoma : is it efficient?

Purpose: To evaluate the extent to which magnetic resonance spectroscopy (MRS) lipid metabolites are accurate in predicting high-grade cervical cancer. Material and methods: This prospective single-centre pilot study included 20 cases with pathologically proven cervical cancer. They underwent pelvic magnetic resonance imaging (MRI) with MRS. Two radiologists, blinded to the histopathological results, with 10 years of experience in gynaecological imaging, independently analysed the MRI images and MRS curves, and a third one resolved any disagreement. Using the histopathological results as a standard test, the receiver operating characteristics (ROC) curve was utilised to calculate the optimal lipid peak (1.3 ppm) cutoff for predicting high-grade cervical cancer. The difference in MRS metabolites between low- and high-grade cervical cancer groups was estimated using the Mann-Whitney test. Results: The study included 11 high-grade and nine low-grade cervical cancer cases based on the histopathological evaluation. A lipid (1.3 ppm) peak of 29.9 was the optimal cutoff for predicting high-grade cervical cancer with 100% sensitivity, 77.8%, specificity, and 90% accuracy. Moreover, there was a significant difference between low- and highgrade cervical cancer cases concerning lipid peak at 0.9 ppm, lipid peak at 1.3 ppm, and the peak of choline with (p-value 0.025, 0.001, and 0.023), respectively. Conclusions: MRS might be considered a useful imaging technique for assessing the grade of cervical cancer and improving the planning of treatment. It shows a good diagnostic accuracy. Therefore, it can be adopted in clinical practice for better patient outcome

Antibacterial and Cytotoxicity Functions of Pomegranate Peel Extracts in Fish Processing

Pomegranate peel extracts, both ethanolic (PPE) and aqueous (PPA), demonstrated a broad spectrum of antibacterial action against Gr+ve and Gr-ve bacteria, with bacterial isolate B2 (G+ve cocci) having the maximum inhibition zone (IZ) 10.5–26.5 mm at concentrations  4.2 mg mL-1 to 267 mg mL-1. PPE's minimum inhibitory concentration (MIC) varies among bacterial strains, with the lowest being 8.3 mg mL-1. Ball-milled nano-scale pomegranate peel (NSPP) with 89.09 nm particle increased IZ 3-fold and decreased MIC significantly. MTT was used to assess the NSPPE's cytotoxicity against the Vero normal kidney and caco cell lines. At lower doses, NSPPE was safe, but increasing concentrations gradually lethal against Vero normal kidney cell line. NSPPE was highly toxic to caco cells, with an IC50 339.76±13.9 µg mL-1. Fish kofta samples treated with NSPPE were completely free of Escherichia coli and Staphylococcus aureus after 8 weeks of storage. This study demonstrates that NSPPE may improve fish food safety and shelf life as a natural preservative

The perceived barriers to insulin therapy among type 2 diabetic patients

Background: Problems may arise with insulin treatment, due to patients\u2019 perspective towards it leading to refusal. Objectives: To evaluate diabetic patients\u2019 refusal towards insulin therapy, and to assess patients' perception and perceived barriers towards insulin. Methods: A cross-sectionalstudy, where type 2 diabetics participated in the study during a period, February through March 2017. They were interviewed in person by a questionnaire including three sections; socio-demography, medical history and a health belief model, comprising barriers to use insulin. Five points Likert scale was used to measure patients\u2019 perception and barriers towards insulin therapy. Results: One fourth (24.4%) of the diabetic patients refused insulin. Among the controlled group, 34.4% refused insulin, while 21% refused insulin among the uncontrolled group. The study showed different barriers towards insulin therapy, including fear of injection, pain, insulin injection needs help from others, fear of hypoglycaemia and embarrassment. Conclusion: Diabetics showed a negative attitude towards insulin therapy due to social and psychological factors. The results necessitate the development of a strategy to address problems related with a reluctance to initiate insulin and put a strategy to implement education and better interaction with diabetic team to the stigma from phobia from insulin use. DOI: https://dx.doi.org/10.4314/ahs.v19i1.39 Cite as: Hussein A, Mostafa A, Areej A, Mona A, Shimaa A, Najd A, et al. The perceived barriers to insulin therapy among type 2 diabetic patients. Afri Health Sci. 2019;19(1). 1638-1646. https://dx.doi.org/10.4314/ahs.v19i1.3

EVALUATION OF LACTOBACILLI PROPERTIES AND THEIR ANTIBACTERIAL SUBSTANCES BY USING SWEET WHEY AS GROWTH MEDIUM AGAINST PATHOGENIC BACTERIA

The increasing demand of consumers who look for natural safe products and associated health risks of chemically treated and refined goods food products led to the introduction of alternative technologies for Preservation and maintenance of dietary freshness. One of such Preservation technology requires the use of Lactobacilli as starter culture for the preservation of food matrixes planned. The present study was designed to evaluate sweet whey low-cost by- product of dairy manufacture as a substrate for the selection of Lactobacilli with proven antibacterial activity to be used as biopreservation for fermented dairy product. Human population has used dairy products, including milk, as a source for Lactic acid bacteria (LAB). The positive impact of the given bacteria as a diet supplement has been of concern to researchers. The target of this study is to examine Lactobacillus species isolated from dairy products i.e. raw milk alongside cheese, with potential activities. Using the Sweet whey as growth medium for Lactic acid bacteria. Also, tested of antibacterial activities. Sweet whey (sw) proved to be suitable medium alternative to the expensive commercial De Man-Regosa-Sharp medium for the growth and production of antibacterial substances by isolated lactic acid bacteria isolates. Therefore, was used throughout the present work. A number of 32 isolates were obtained from raw cow milk (16 isolates), goat milk (9 isolates) and cottage cheese (7 isolates) using the specific De Man-RegosaSharp medium (MRS) for the isolation of LAB, these isolates were identified up to genus as strains of Lactobacillus spp. Among 32 isolates of Lactobacillus spp., there are twenty four isolates antagonized of the all seven tested pathogenic bacteria. The screened Lactobacillus spp. isolates were characterized and selected the best bio agent isolate against pathogens was identified using 16s DNA gene to Lactobacillus brevis. This strain was resistant to NaCl (2-6.5 %), produces dioxide carbon (CO2) and showed good growth in different temperature (10°, 15, 45°C) and fermented of many sugars. As per the outcomes shown herein, the strain in question was thought to be antimicrobial bacterium produced a variety of metabolites, including butyric, formic, lactic, citric, and sorbic acid. The given set of activities adds to microbiological safety by helping control microorganism growth, and inhibiting pathogenic bacteria by using the lower-cost sweet whey. Therefore, more detailed work on isolating and characterizing antibacterial bacteria from the locally produces dairy items, and augmenting their growth could be needed for the creation of biopreservative foods

Measurements of the pp → ZZ production cross section and the Z → 4ℓ branching fraction, and constraints on anomalous triple gauge couplings at √s = 13 TeV

Four-lepton production in proton-proton collisions, pp -> (Z/gamma*)(Z/gamma*) -> 4l, where l = e or mu, is studied at a center-of-mass energy of 13 TeV with the CMS detector at the LHC. The data sample corresponds to an integrated luminosity of 35.9 fb(-1). The ZZ production cross section, sigma(pp -> ZZ) = 17.2 +/- 0.5 (stat) +/- 0.7 (syst) +/- 0.4 (theo) +/- 0.4 (lumi) pb, measured using events with two opposite-sign, same-flavor lepton pairs produced in the mass region 60 4l) = 4.83(-0.22)(+0.23) (stat)(-0.29)(+0.32) (syst) +/- 0.08 (theo) +/- 0.12(lumi) x 10(-6) for events with a four-lepton invariant mass in the range 80 4GeV for all opposite-sign, same-flavor lepton pairs. The results agree with standard model predictions. The invariant mass distribution of the four-lepton system is used to set limits on anomalous ZZZ and ZZ. couplings at 95% confidence level: -0.0012 < f(4)(Z) < 0.0010, -0.0010 < f(5)(Z) < 0.0013, -0.0012 < f(4)(gamma) < 0.0013, -0.0012 < f(5)(gamma) < 0.0013

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Electroweak production of two jets in association with a Z boson in proton-proton collisions root s =13 TeV

A measurement of the electroweak (EW) production of two jets in association with a Z boson in proton-proton collisions at root s = 13 TeV is presented, based on data recorded in 2016 by the CMS experiment at the LHC corresponding to an integrated luminosity of 35.9 fb(-1). The measurement is performed in the lljj final state with l including electrons and muons, and the jets j corresponding to the quarks produced in the hard interaction. The measured cross section in a kinematic region defined by invariant masses m(ll) > 50 GeV, m(jj) > 120 GeV, and transverse momenta P-Tj > 25 GeV is sigma(EW) (lljj) = 534 +/- 20 (stat) fb (syst) fb, in agreement with leading-order standard model predictions. The final state is also used to perform a search for anomalous trilinear gauge couplings. No evidence is found and limits on anomalous trilinear gauge couplings associated with dimension-six operators are given in the framework of an effective field theory. The corresponding 95% confidence level intervals are -2.6 <cwww/Lambda(2) <2.6 TeV-2 and -8.4 <cw/Lambda(2) <10.1 TeV-2. The additional jet activity of events in a signal-enriched region is also studied, and the measurements are in agreement with predictions.Peer reviewe