In recent years, infections frequently attributed to Pseudomonas aeruginosa and Acinetobacter baumannii have been seen not only in ICU settings but also in trauma patients following natural disasters, as well as in individuals with pre-existing conditions within the community. These non-fermenting bacteria are known to cause hospital-acquired bloodstream infections, especially in patients who are debilitated or immunocompromised. All non-fermenting Gram-negative bacteria (NFGNB) isolates from different clinical samples received in the clinical microbiology laboratory from outpatients and inpatients at Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, were included in the study. Routine microscopy of these samples was conducted. Gram staining was realized for all samples except for urine. All clinical samples were inoculated on blood agar and MacConkey agar and were incubated at 37°C for 18–24 hours. Colony characteristics were observed. All the organisms that produced pale or colorless colonies on MacConkey agar and also showed GNB on Gram staining of the colonies were considered to be NFGNB and further identified by the VITEK 2 compact system. Antimicrobial susceptibility testing of the isolated non-fermenting Gram-negative bacteria was conducted using the Kirby-Bauer disc diffusion method. In the study, it was reported that the majority out of 879 (100%) isolates of NFGNB were P. aeruginosa 415 (47.21%), followed by Ac. baumannii 380 (43.23%), and the majority of specimens were from endotracheal (ET) (30.60%), followed by pus swab (19.11%), blood (16.15%) and urine (10.01%) samples. The majority of isolates were the males in the age group of 61-70, i.e.121 (13.76%), followed by the age group 41-50, i.e., 113 (12.85%). P. aeruginosa was most commonly isolated from pus swabs (13.42%), while Ac. baumannii was isolated most commonly from ET (21.4%). Based on this study, it can be concluded that as antibiotic resistance rises, treating infections caused by NFGNB will become increasingly challenging unless proactive measures are implemented and new antibiotics are developed. To curb the spread of resistant strains of Pseudomonas aeruginosa and Acinetobacter, it is crucial to enforce stringent infection control practices, ensure collaboration between clinicians and laboratory personnel regarding antibiotic use, and adhere to strict hospital hygiene protocols.
Paneth cells (PCs) are specialized epithelial cells located at the base of the crypts of Lieberkühn in the small intestine and colon, that have been occasionally identified in colorectal adenomas and adenocarcinomas. Their presence in these lesions has raised questions regarding their role in colorectal neoplasia and their potential association with adenoma burden. To understand their potential role in carcinogenesis, we conducted an extensive review of the available literature on PubMed, focusing on the occurrence, molecular mechanisms, and implications of Paneth cells in neoplastic lesions of the colorectum. This review synthesizes current findings and discusses the potential of Paneth cells as diagnostic biomarkers and therapeutic targets in colorectal cancer.
The phenomenon of substance use disorders (SUDs) presents extremely complex etiopathogenesis with intermingled psychological, social, economic, and biological factors. Therefore, the prophylactic and therapeutic approach is multidimensional and should involve targeting all the aforementioned variables. However, it is frequently difficult to separate these factors and construct specific strategies to mitigate their direct negative effects, so caution is needed when formulating recommendations for this population, starting from guidelines for case management and finishing with optimization of healthcare policies. Based on the lack of good practices approved at the national level in Romania for the prevention and treatment of SUDs, this article suggests a draft for such an instrument that could help both clinicians and decisional factors with attribution in healthcare and drug abuse prevention. The methods used in this article are (1) a literature review of studies, guidelines, and other reviews focused on specific aspects of drug abuse/dependence and (2) expert opinions derived from clinical and administrative experience. The results are formulated as recommendations, scored according to the GRADE system, and grouped into three categories: (1) preventative measures for SUDs, (2) secondary prophylaxis, (3) therapeutic and other SUD-targeted interventions. In conclusion, the need for guidelines and policies focused on the prevention and treatment of SUDs, especially in vulnerable populations, is an unmet need in our country. The suggested algorithm in this paper tried to bridge the gap between the available literature dedicated to SUDs, practical experience, and future policies in the healthcare of patients with SUDs.
Patients' trust in their physicians is reflected in their steadfast confidence, which encourages greater patient cooperation in treatment, thereby enhancing the prognosis of the disease. We aimed to evaluate the validity and reliability of the Trust in Physician Scale questionnaire (TIPS) by translating it into Persian. After obtaining the main author's permission, the forward- backward translation technique was employed to develop the Persian version. We conducted a cross-sectional study utilizing the TIPS questionnaire among adult patients who presented to the hospital emergency room. This survey involved 310 patients, of which 157 (50.6%) were male and 153 (49.4%) were female. During the study, the mean and standard deviation of patients' age were 56.6 and ± 20.6 years, respectively. The Cronbach's alpha coefficient for this scale was 0.875, demonstrating good internal consistency of the questionnaire. Using factor analysis, the scale items filled one subgroup. To evaluate the reliability of this test, the intra-class correlation coefficient (ICC) was determined to be 0.75, confirming its reliability. This study demonstrated acceptable validity and reliability of the TIPS questionnaire for evaluating patients' trust in their physicians in a Persian-speaking society.
Bacterial resistance to antibiotics is considered the most important health problem in developed and developing countries. Studies on new pharmaceutical strategies, such as probiotics and their derivatives, have increased. The purpose of this study is to isolate and purify bacteriocin and biosurfactant from Lactobacillus rhamnosus and investigate its antibacterial and anti-biofilm activity. Bacteriocin and biosurfactant produced by Lactobacillus rhamnosus standard strain were isolated and purified. Biosurfactant screening tests, including oil expansion test and drop spreading test, were conducted. Bacteriocin was separated using two different methods, including separation with the help of 2-propanol and separation with the help of ammonium sulfate. The purification of bacteriocin was realized by dialysis, and the effect of biosurfactant and bacteriocin on Staphylococcus aureus and Escherichia coli was realized using the disc diffusion method. The antibacterial properties of these substances were determined by diffusion method from its anti-biofilm disk with the help of the ELISA reader. Statistical Program for Social Sciences (SPSS) software was utilized for data analysis. The diameter of the non-growth halo of E.coli in contact with the disc impregnated with bacteriocin in concentrations of 250, 500, and 1000mg/ml was 21 ± 1, 21.33 ± 2.3 and 34.66 ± 7.02 mm, respectively, and in Staphylococcus aureus was evaluated as 18.33 ± 3.78, 24.33 ± 4.72 and 43.66 ± 4.72 mm, respectively. The order was evaluated as 18.33 ± 2.88, 25 ± 5, 43.33 ± 5.77 mm. The biofilm inhibition percentage was measured for Escherichia coli 0.36, 2.15, and 71.75%, respectively, and for Staphylococcus aureus 1.07%, 5.96%, and 53.3%, respectively, at the mentioned concentrations. The results showed that bacteriocin and biosurfactant isolated from Lactobacillus rhamnosus have high antibacterial and anti-biofilm properties
AB0 blood group type has been linked with different types of cancer. For rectal cancer, there isn’t enough data to assess whether such risk exists. We conducted a retrospective study to evaluate the association between ABO blood type and risk of susceptibility to development, progression, or protection against rectal cancer. We analyzed the medical records of 690 patients with rectal cancer from “Prof. Dr. Alexandru Trestioreanu” Oncological Institute of Bucharest during 8 years of follow-up. Data were scraped using Python. For analysis, we used the Chi-square test. The blood group count was A (287, 41.6.%) followed by 0 (250, 36.2%), B (32, 4.6%), and AB (121, 17.5%). There are no differences in the female and male subgroups regarding blood type and the lack of evidence for the null hypothesis rejection was shown using the χ2 test statistic (χ2 = 2.1, d.f. 3, p = 0.55 for males and χ2 = 2.9, d.f. 3, p = 0.4 for females). These findings are consistent with the notion that even if AB0 blood type is a risk factor for many types of cancer, there is no specific association between rectal cancer and blood group type.
Ultrasonography (US) is one of the most widely utilized imaging methods in contemporary medical practice. Unlike other imaging techniques primarily within the radiology domain, ultrasonography has been adopted by various medical and surgical specialties and tailored to the specific needs of each. This adaptability has contributed to ultrasonography's rapid diversification and remarkable evolution over recent decades. Ultrasonography was first employed in dermatology in 1979 when Alexander et al. used it to measure skin thickness. However, due to the limitations of conventional ultrasound devices at the time, which had resolutions and frequencies below 15 MHz, detailed elements of the skin could not be analyzed, tempering enthusiasm for the technique [2]. Modern dermatologic ultrasonography began with the development of fixed-frequency devices operating above 20 MHz, enabling detailed visualization of skin structures. Numerous studies on skin physiology and pathophysiology were conducted using this approach. Modern ultrasonography enables us to visualize skin structures, at times surpassing the detail provided by traditional anatomical dissections in educational settings. Given that patient safety and quality medical care remain fundamental priorities, ultrasonography, with its safety profile and versatility, represents the next step in modern dermatology. Ultrasonography represents a rapidly evolving diagnostic tool that holds the promise of significantly improving diagnostic accuracy and the quality of medical dermatology practice.
Psoriasis is a chronic, inflammatory, immune-mediated skin disease affecting 1-3% of the adult population. It mainly involves the skin, nails, and joints. However, psoriasis can be associated with several comorbidities, including ocular complications. The most frequently reported pathologies are dry eyes syndrome, blepharitis, and uveitis. Being a systemic inflammatory disease, psoriasis also has the potential to directly affect the retina. It has been reported that ocular manifestations tend to appear much later than skin and joint involvement. Eye complications begin insidiously, and progress asymptomatically. This can lead to a decrease in the quality of life and even permanently compromised visual function if not treated properly. Thus, the present review aimed to present current pathological explanations between psoriasis and ocular manifestation, and to evaluate the prevalence of ocular changes in patients with psoriasis, in order to be diagnosed and managed appropriately.
Pancreaticoduodenectomy (PD) is a complex procedure with a high complication rate. Postoperative pancreatic fistula (POPF) is a major complication. Therefore, preoperative determination of POPF risk is clinically important. The C-reactive protein- albumin ratio (CAR) is a parameter used for prognosis in some types of cancer. We hypothesized that CAR could serve as a predictive parameter of POPF. In this study, we investigated whether CAR can predict the risk of POPF after PD in patients with pancreatic cancer. Methods: A total of 83 patients were included in this study between March 2017 and December 2023. This retrospective evaluation included demographic characteristics, preoperative laboratory findings, preoperative clinic and hospital records, and the surgical and treatment conditions of patients undergoing PD for pancreatic cancer in our department. Results: POPF was observed in 41 patients. CAR value was significantly elevated in the POPF group (P< 0.001). According to the Receiver Operating Characteristic (ROC) analysis results, the optimal cut-off point determined for CAR was 0.445. Univariate and Multivariate Binary Logistic Regression analyses showed that CAR was reliable for predicting POPF (odds 57.2). Conclusion: Preoperative CAR is a reliable predictive marker for POPF following PD.
Atypical fibroxanthoma and hemosiderotic dermatofibroma are both dermal tumors that can raise significant challenges for differential diagnosis. The definitive diagnosis is established based on histopathological appearance and immunohistochemistry. The aim of this paper is to present the differential diagnosis challenges encountered in the case of a 67-year-old male patient who developed within a month, following trauma to the lower third of the right thigh, a large asymptomatic tumor with an irregular outline.
