An-Najah Blogs :: Adham Abu Taha An-Najah Blogs :: Adham Abu Taha en-us Thu, 21 Nov 2019 17:29:04 IST Thu, 21 Nov 2019 17:29:04 IST Antibiotic Resistance of Bacterial Strains Isolated from Patients with Community-Acquired Urinary Tract Infections: an Exploratory Study in Palestine. ArticlesBackground and Objectives: No studies about resistance of bacteria isolated from patients with community-acquired urinary tract infections CA-UTI or local guidelines for antibiotic use in these infections have been published or established in the West Bank Palestine The objectives of this study were to determine the 1 type and frequency of isolated bacteria and 2 their resistance to commonly used antibiotics Methods: A cross sectional study on community urinary isolates was carried out in Nablus Palestine between November 2009 and April 2010 A convenience sampling method was used for collection of specimens Results: A total of 375 specimens were collected from 306 816 females and 69 184 males Three hundred and thirty nine 904 of isolated uropathogens were Gram-negative bacteria of which 243 717 were Escherichia coli Thirty six 96 of the total isolates were Gram-positive bacteria of which 21 583 were Staphylococcus saprophyticus High resistance rates were recorded for E coli against trimethoprimsulfamethoxazole 37 nitrofurantoin 29 ampicillin 65 and nalidixic acid 37 E coli showed low resistance to amoxicillinclavulanic acid ciprofloxacin cefotaxime and ceftriaxone with rates of 122 172 111 and 111 respectively Conclusion: E coli was the most frequent bacterium in the studied sample and showed high resistance to first-line antibiotics Our results highlight the need for developing local guidelines where elevated resistance to antibiotics should influence prescribing decisionsSleep habits and sleep problems among Palestinian students. ArticlesAbstract ABSTRACT: Aim: The aim of this study was to describe sleep habits and sleep problems in a population of undergraduates in Palestine Association between self-reported sleep quality and self-reported academic achievement was also investigated METHODS: Sleep habits and problems were investigated using a convenience sample of students from An-Najah National University Palestine The study was carried out during spring semester 2009 A self-administered questionnaire developed based on The Diagnostic and Statistical Manual of Mental Disorders IV criteria and Pittsburgh Sleep Quality Index was used RESULTS: 400 students with a mean age of 202 - 13 were studied Reported mean duration of night sleep in the study sample was 64 - 11 hours The majority 583 of students went to bed before midnight and 18 of the total sample woke up before 6 am Sleep latency of more than one hour was present in 193 of the students Two thirds 648 of the students reported having at least one nocturnal awakening per night Nightmares were the most common parasomnia reported by students Daytime naps were common and reported in 745 of the study sample Sleep quality was reported as \poor\ in only 98 and was significantly associated with sleep latency frequency of nocturnal awakenings time of going to bed nightmares but not with academic achievement CONCLUSION: Sleep habits among Palestinian undergraduates were comparable to those reported in European studies Sleep problems were common and there was no significant association between sleep quality and academic achievementDIABETES MELLITUS TYPE 2 IS NOT A RISK FACTOR FOR AMINOGLYCOSIDE INDUCED RENAL INJURY Articles The aim of the study was to investigate the extent and time course of aminoglycoside AG-induced serum creatinine elevation in patients with and without type 2 diabetes mellitus DM2 This prospective study included patients with and without DM2 who were administered AG parenterally The outcome of interest was the extent and time course of serum creatinine elevation suggestive of renal injury during AG therapy Data were entered and analyzed using a statistical package for social sciences SPSS 16 Of 94 patients included in the study there were 42 DM2 and 52 non-DM2 patients There was no significant between-group difference in initial P=018 and final serum creatinine P=015 Furthermore no significant difference in serum creatinine elevation was observed between patients with and without DM2 during the course of AG therapy Eleven 262 of 42 DM2 patients and 13 25 of 52 non-DM2 patients had an increase of ?442 molL in serum creatinine level during therapy P=089 In DM2 group a significant rise P=004 in serum creatinine level was evident on day 4 and maximum rise 28 from baseline value was evident on day 6 of therapy Similar extent and time course of serum creatinine elevation was observed in non-DM2 group In conclusion type 2 diabetes mellitus is not a risk factor for aminoglycoside-induced renal injury Vulnerability of cough syrups marketed in Palestine to microbial Articles ABSTRACT Microbial contamination of cough syrups can bring clinical hazards as well as physical changes in the product The objective of the current investigation was to assess and compare the ability of imported and locally manufactured cough syrups to maintain minimum or no microbial growth after being challenged with different types of microbes The growth of five microorganisms of known quanta of S aureus E coli P aeruginosa and C albicans was compared among five different cough products designated A through E Two of the products A and E were locally manufactured while three B C and D were imported products which contained different preservatives Both A and E did not indicate the type of preservative used Normal saline was used as a positive growth control Growth of microorganisms into syrups was compared by counting the colony forming units CFUs from a subculture of inoculated syrups at zero 3 6 24 and 48 hr intervals 1 at time zero growth of S aureus was seen in all products except product B; 2 little or no growth of C albicans P aeroginosa and E coli was observed at time zero; 3 no growth of any of the tested microbes was seen when subcultures were done after 6 hours of inoculation; and 4 imported products showed lesser or no microbial growth compared to locally manufactured ones Normal saline showed heavy growth of all tested microbes while unchallenged syrupsof the tested products showed no signs of microbial growth at all tested timesDespite the noticeable growth of S aureus at time zero all tested cough syrups passed the pharmacopeal guidelines regarding microbial challenge Good manufacturing and packaging practices need to be implemented and maintained by local pharmaceutical companies The Palestinian general public needs to be educated on the proper handling and storage of oral liquid pharmaceuticals to eliminate or reduce microbial contamination GENE REGULATION OF α4β2 NICOTINIC RECEPTORS: MICROARRAY ANALYSIS OF NICOTINE-INDUCED α4β2 UP-REGULATION AND ANTI-INFLAMMATORY EFFECTS Articlesalpha4beta2 Nicotinic acetylcholine receptors play an important role in the reward pathways for nicotine We investigated whether receptor up-regulation of alpha4beta2 nicotinic acetylcholine receptors involves expression changes for non-receptor genes In a microarray analysis 10 muM nicotine altered expression of 41 genes at 025 1 8 and 24 h in halpha4beta2 SH-EP1 cells The maximum number of gene changes occurred at 8 h around the initial increase in 3[H]-cytisine binding Quantitative RT-PCR corroborated gene induction of endoplasmic reticulum proteins CRELD2 PDIA6 and HERPUD1 and suppression of the pro-inflammatory cytokines IL-1beta and IL-6 Nicotine suppresses IL-1beta and IL-6 expression at least in part by inhibiting NFkappaB activation Antagonists dihydro-beta-erythroidine and mecamylamine blocked these nicotine-induced changes showing that receptor activation is required Antagonists alone or in combination with nicotine suppressed CRELD2 message while increasing alpha4beta2 binding Additionally small interfering RNA knockdown of CRELD2 increased basal alpha4beta2 receptor expression and antagonists decreased CRELD2 expression even in the absence of alpha4beta2 receptors These data suggest that endoplasmic reticulum proteins such as CRELD2 can regulate alpha4beta2 expression and may explain antagonist actions in nicotine-induced receptor up-regulation Further the unexpected finding that nicotine suppresses inflammatory cytokines suggests that nicotinic alpha4beta2 receptor activation promotes anti-inflammatory effects similar to alpha7 receptor activationMedication dosing errors in hospitalized patients with renal impairment: a study in Palestine ArticlesBackground and Aim Reduced renal function requires dose adjustment for certain drugs to avoid toxicity The aim of this study was to determine whether appropriate dosage adjustments were made for drugs that are nephrotoxic excreted or metabolized TEM medications by the kidney in patients with renal impairment Methodology A cross-sectional study of a group of hospitalized patients was carried out at Al-Watni governmental hospital Nablus Palestine All patients with creatinine clearance 59 mlmin were included in the analysis Data regarding patients clinical laboratory findings and medications whether they were prescribed at hospital or at discharge were collected from patients medical files Evaluation of appropriate dosing was based on Physician Disk Reference PDR All data were collected for further research and subsequent statistical analysis using statistical package for social sciences SPSS for windows version 10 Results A total of 78 patients had calculated creatinine clearance 59 mlmin Those patients were prescribed a total of 1001 lines of prescription medication Dosage adjustment was necessary for 193 TEM medications Analysis of TEM medications with guidelines for adjustment indicated that 7358142 were found to be inappropriate and 2642 51 were found to be appropriate The most common inappropriate medications were ranitidine antibiotics and digoxin Approximately 775 of the unadjusted medications were prescribed during hospitalization Conclusion In our study a wide range of dosing errors was common among patients with renal impairment that was common during hospitalization Continued medical education in the field of clinical pharmacokinetics is important for physicians Admission blood glucose level as a potential indicator for short-term mortality and morbidity after myocardial infarction ArticlesHyperglycemia is common among patients with acute myocardial infarction AMI and is associated with high risk of mortality and morbidity However the relationship between admission plasma glucose APG levels and mortality in diabetic and nondiabetic patients with AMI needs further investigation The aim of this study was to investigate the relationship between APG level and short-term mortality and morbidity after AMI Materials And Methods : This is a prospective study of 79 consecutive patients with AMI followed up for 90 days Medical history as well as demographic and clinical baseline characteristics of the patients was obtained from Al-Watni Governmental Hospital medical records The patients were divided into four groups based on APG levels Patients\ health status was followed up by phone call interviews with the patients and their families Follow-up data were further confirmed using patients\ medical records at the hospital The phone interviews investigated all causes of death or congestive heart failure CHF or re-infarction Results : The mean age of patients was 619 123 years At the time of hospital admission the median PG level was 162 mgdl During the 3-month follow-up overall mortality was 203 and was increased to 563 in patients with glucose levels 200 mgdl Mortality was comparable 219 vs 191; P 005 between diabetic and nondiabetic patients Nonfatal adverse outcomes in the form of combined CHF and re-infarction were highest in group IV and lowest in group I Conclusion :Our study demonstrates that high APG level is common in patients with AMI and is associated with high risk of mortality and morbidity among patients with or without diabetes mellitus In fact our study showed that nondiabetic patients with high APG have higher risk of mortality than patients with a known history of diabetes mellitus Int J Diab Dev Ctries 2006;26:116-21 Bispecific enzyme-linked signal-enhanced immunoassay with subattomole sensitivity. ArticlesA bispecific enzyme-linked signal-enhanced immunoassay BiELSIA was developed with markedly increased sensitivity Antimyosin the detection antibody was linked to the signal probespecific antibody Probes consisted of diethylenetriamine pentaacetic acids attached to polylysine modified with up to seven or eight horseradish peroxidase HRP units Each bispecific antibody bound two polymer probes providing twice the signal Using BiELSIA in a competitive inhibition immunoassay format with an average of 15 3 45 6 and 75 HRP units per polymer-probe the sensitivity of standard enzyme-linked immunosorbent assay 1013 mole was increased to 1015 1018 1019 1020 and 10-21 mol or = 1000 molecules respectively BiELSIA detected cardiac myosin heavy chain fragments in sera of patients obtained at the time of emergency department admission for acute myocardial infarction but not in normal sera This technology should be applicable for detection of cancer human immunodeficiency virus prion and other antigens that are present in concentrations too low for detection by current immunoassays