30 research outputs found
In vitro activity of antimicrobial agents against extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae at a tertiary care center in Lebanon
No full textLooking for therapeutic options, we assessed the minimum inhibitory concentrations (MICs) of 7 antimicrobial agents against extended-spectrum β-lactamase-producing Klebsiella pneumoniae (n = 58) and Escherichia coli (n = 84) isolates. High rates of susceptibility were shown for both E coli and K pneumoniae against ertapenem (100percent for both), piperacillin-tazobactam (83percent and 91percent, respectively) and amikacin (96percent and 82percent, respectively). In addition, most K pneumoniae isolates were susceptible to quinolones (72percent-75percent) and cefepime (88percent). However, clinical correlation is warranted. Copyright © 2005 by the Association for Professionals in Infection Control and Epidemiology, Inc.Araj G F, 2000, J Med Liban, V48, P221; Bradford PA, 2001, CLIN MICROBIOL REV, V14, P933, DOI 10.1128-CMR.14.4.933-951.2001; Iqbal M, 2002, J Pak Med Assoc, V52, P407; Jones LE, 1997, J ECON DYN CONTROL, V21, P1, DOI 10.1016-0165-1889(95)00924-8; KANAFANI ZA, 2004, 44 ICAAC OCT 29 NOV; Kanj S S, 2001, J Med Liban, V49, P13; Livermore DM, 2001, ANTIMICROB AGENTS CH, V45, P2831, DOI 10.1128-AAC.45.10.2831-2837.2001; National Committee for Clinical Laboratory Standards, 2002, M100S12 NAT COMM CLI; Nishino Takeshi, 2002, Nihon Rinsho, V60, P2216; Paterson DL, 2001, J CLIN MICROBIOL, V39, P2206, DOI 10.1128-JCM.39.6.2206-2212.2001; Samaha-Kfoury JN, 2003, BRIT MED J, V327, P1209, DOI 10.1136-bmj.327.7425.1209; Spanu T, 2002, ANTIMICROB AGENTS CH, V46, P196, DOI 10.1128-AAC.46.1.196-202.2002; Zanetti G, 2003, ANTIMICROB AGENTS CH, V47, P3442, DOI 10.1128-AAC.47.11.3442-3447.200396
Soft Evaluation
No full textIn this chapter, the author describes an alternative approach to evaluating Information Technology (IT) projects, which involves developing a holistic view of IT interventions. The main methodological problem in evaluating any intervention is to choose the right indicators for the measurement of success or lack of it. These indicators will obviously be linked to the aims but will also be relevant to the objectives chosen to achieve these aims. Acknowledging the difficulty of choosing appropriate measures of performance, the author proposes the use of Soft Evaluation. The approach used brings together formal work in evaluation with a qualitative process of investigation based on Soft Systems Methodology in order to allow us to make judgements about the outcomes of an implementation in a systemic manner and from a number of different viewpoints or perspectives.</jats:p
Prevalence of antibodies against hepatitis B virus and hepatitis C virus among blood donors in Lebanon, 1997-2003
No full textThe prevalence of hepatitis B virus (HBV) antigens (HBsAg) and antibody to hepatitis C virus (anti-HCV) was determined among 16,084 blood donors (14,993 males; mean age, 31.7 ± 8.2 years and 1084 females; mean age, 31.4 ± 8.2 years) in the period 1997-2003. Of the donors screened, 149 were HBsAg positive (0.926percent), and 65 were anti-HCV positive (0.404percent). There was a steady decline in HBsAg prevalence from 1.56percent (1997) to 0.33percent (2003) and in anti-HCV from 1.22percent (1997) to 0.16percent (2003). Females had a higher prevalence of anti-HCV (P = .031) and HBsAg (P = .047). Results obtained are of value in light of the occurrence of HBV and HCV transmission by nonparenteral routes. © 2006 Association for Professionals in Infection Control and Epidemiology, Inc.Anzola M, 2004, J VIRAL HEPATITIS, V11, P383, DOI 10.1111-j.1365-2893.2004.00521.x; Beld M, 1999, HEPATOLOGY, V29, P1288, DOI 10.1002-hep.510290442; Bizollon T, 2000, GUT, V47, P698, DOI 10.1136-gut.47.5.698; Blakely TA, 1999, INT J EPIDEMIOL, V28, P204, DOI 10.1093-ije-28.2.204; Burnouf T, 2000, BLOOD REV, V14, P94, DOI 10.1054-blre.2000.0129; Irani-Hakime N, 2001, CLIN LAB HAEMATOL, V23, P317, DOI 10.1046-j.1365-2257.2001.00409.x; Kleinman S, 1997, TRANSFUS MED REV, V11, P155, DOI 10.1053-tmrv.1997.0110155; Nabulsi Mona M, 2003, J Med Liban, V51, P64; Naman R E, 1996, J Med Liban, V44, P4; NASSAR NT, 1976, J HOPKINS MED J S, V139, pS45; Takano S, 1996, HEPATOLOGY, V23, P708, DOI 10.1002-hep.510230408; Wasley A, 2000, SEMIN LIVER DIS, V20, P1, DOI 10.1055-s-2000-950697
Herpes simplex keratitis following coronavirus disease 2019 vaccination: an observational study of forty-three cases with different presentations
No full textObjective The aim of this study was to evaluate the cases diagnosed with different presentations of herpes simplex virus (HSV) keratitis following coronavirus disease 2019 (COVID-19) vaccination and to describe the relationship between the disease presentation, the type of vaccine, and the duration between vaccination and disease onset.
Patients and methods This is a retrospective observational clinical study of HSV keratitis cases that was carried out by the Cornea Team at Alexandria Ophthalmology Hospital, Alexandria, Egypt, between March and September 2022. Full medical and ophthalmic history was taken, followed by a thorough ophthalmic examination. The vaccination data of the patients were recorded. The hospital records of the patients visiting the outpatient clinics, at that period, were collected regarding the number of vaccinated and nonvaccinated patients and the type of vaccine received.
Results The study included 43 eyes of 43 patients. Typical dendritic corneal ulcer occurred in 21 (48.8%) eyes, while 5 (11.6%) eyes presented with a geographic ulcer, and 14 (32.6%) eyes were diagnosed as interstitial keratitis with or without ulceration. The remaining 3 (6.98%) eyes presented with disciform keratitis. Vaccination was previously received by 40 (93.02%) patients, while only 3 patients did not receive any vaccine. Oxford-Astra Zeneca vaccine was received by 14 (35%) patients, while the Pfizer-BioNTech vaccine was received by 13 (32.5%) patients, Sinovac vaccine by 10 (25%) patients, and other types of vaccines by three (7.5%) patients. The duration between the last dose received from the vaccine and the onset of symptoms ranged between 2 and 58 days (mean=18.35±13.3 days). Reviewing the hospital records, out of the 65 321 patients who visited the hospital during that period, 47% were nonvaccinated, and 53% were vaccinated with one dose or more of COVID-19 vaccine (Odds ratio=11.8207 indicating a significant association between HSV keratitis and vaccination).
Conclusion Reactivation of HSV keratitis may follow COVID-19 vaccination with different presentations of herpetic keratitis. The Oxford-AstraZeneca and the Pfizer-BioNTech vaccines were significantly associated with HSV ocular infection more than any other type of vaccine
An investigative and evaluative study of factors affecting quality of agricultural and farm information services in Kerala
No full textAgriculture is not only a country’s backbone of food, livelihood and ecological security systems, but is also the very soul of its sovereignty. In Kerala population density is high and land is scarce. To achieve sustainable advancement in quality of human life, meeting the domestic food requirement is to be given foremost priority in development plans. As the area of cultivation cannot be increased and growth of population cannot be controlled growth in food production is to be achieved by qualitative improvement in farming. This requires improvements in material inputs, farming techniques, storage technology and research. Effective integration of these factors is tied closely to adequate information flow, which can be ensured only by an efficient information system for agricultural education, research, extension and development. So evaluation and improvement of existing information services is very crucial for sustainable agricultural growth. The study evaluates the existing information resources, facilities, services, possibilities for resource sharing, accessibility of external sources, and the factors that affect the quality and efficiency of information services in agricultural sector. Coverage is limited to the State of Kerala. Sample consist 105 institutions of different levels, and information users consisting of 426 scientists and 220 farmers. Different sets of questionnaires and interview schedule were used to elicit information. The study found that agricultural research conducted at various institutions in the region at huge public expense has generated knowledge for improving production. Along with these huge collections of acquired content is also stored in the sector. But when a farmer, an extension worker, a scientist or an administrator needs information it is not easily accessible. The study found that agricultural sector fails to effectively bank on information resources available due to the lack of an information system and network. Recommends an Agricultural and Farm Information System for Kerala. Suggests a model plan for a computer communication network for resource sharing between the agricultural institutions in the State, which will also ensure, smooth flow of results of research down to the grassroots level to achieve maximum productivity in agriculture
Modeling emergency departments using discrete event simulation techniques
No full textThis paper discusses the application of Discrete Event Simulation (DES) for modeling the operations of an Emer-gency Department (ED). The model was developed to help the ED managers understand the behavior of the system with regards to the hidden causes of excessive waiting times. It served as a tool for assessing the impact of major departmental resources on Key Performance Indicators (KPIs), and was also used as a cost effective method for testing various what-if scenarios for possible system im-provement. The study greatly enhanced managers’ under-standing of the system and how patient flow is influenced by process changes and resource availability. The results of this work also helped managers to either reverse or modify some proposed changes to the system that were previously being considered. The results also show a possible reduc-tion of more than 20% in patients waiting times
Detection of bleeding disorders in lebanon: Outcomes of a pilot programme
No full textTo promote management and awareness of bleeding disorders in Lebanon, a pilot programme was launched in 2009 by the Lebanese Hemophilia Association assisted by World Federation of Hemophilia. The aim of this study was to diagnose patients with bleeding disorders and to assess the potential challenges in implementing a screening programme. The pilot project was launched in 26 social health centres in the Bekaa valley. The study tools included the evaluation of the Tossetto Bleeding Score and the Pictorial Bleeding Assessment Chart (PBAC) for menstruation. Persons with a bleeding score higher than 2 and PBAC higher than 185 were eligible for further blood tests including the prothrombin time, partial thromboplastin time, complete blood count, bleeding time and von Willebrand ristocetin cofactor activity. 643 patients were enrolled, of whom 60.6percent were women. Overall, 91 persons had an abnormal score. 50 eligible patients were tested: 32 had normal tests, nine new patients with severe Von Willebrand were discovered, 4 had VW:RiCo of 40, 3 prolonged APTT and 2 thrombocytopaenia. There was a clear correlation between the severity of the score and the willingness to perform the tests (P = 0.02). Women were reluctant to participate fully when investigators were men. The probability of adherence to the screening protocol is significantly increased when directed by women health care professional. For patients with milder forms, global screening programmes were neither feasible nor acceptable but those more severely affected have to be identified. Providers are crucial in preselecting patients with blood problems who are not coping well. © 2013 John Wiley and Sons Ltd.Djambas KC, 2006, 27 INT C WORLD FED H; HIGHAM JM, 1990, BRIT J OBSTET GYNAEC, V97, P734, DOI 10.1111-j.1471-0528.1990.tb16249.x; JANSSEN CAH, 1995, OBSTET GYNECOL, V85, P977, DOI 10.1016-0029-7844(95)00062-V; Manisha M, 2002, HAEMATOLOGIA, V32, P39, DOI 10.1163-156855902760262754; Meriane F, 1991, BLOOD S, V78, p48a; Miller CH, 1987, BLOOD S, V70, p377a; Philipp CS, 2011, AM J OBSTET GYNECOL, V204, P2091; RODEGHIERO F, 1987, BLOOD, V69, P454; Srivastava A, 1998, HAEMOPHILIA, V4, P33, DOI 10.1046-j.1365-2516.1998.0040s2033.x; Tosetto A, 2011, J THROMB HAEMOST, V9, P1143, DOI 10.1111-j.1538-7836.2011.04265.x; Tossetto A, 2008, HAEMOPHILIA, V14, P415; Trasi S, 2005, INDIAN J MED RES, V121, P6530
Tigecycline in vitro activity against commonly encountered multidrug-resistant Gram-negative pathogens in a Middle Eastern country
No full textThe lack of data from the Middle East warranted studying tigecycline in vitro activity in Lebanon against consecutive multidrug-resistant (MDR) bacteria, including extended-spectrum β-lactamases producing clinical isolates of Escherichia coli (n = 150), Klebsiella pneumoniae (n = 100), and Acinetobacter spp. (n = 64) using the standard disk diffusion method. Tigecycline-resistant and intermediate findings were as follows: E. coli, 0percent and 0percent; K. pneumoniae, 3percent and 16percent; and Acinetobacter spp., 0percent and 2percent. These values were substantially lower than those determined for amikacin, gentamicin, tobramycin, ciprofloxacin, piperacillin-tazobactam, amoxicillin-clavulanic acid, and trimethoprim-sulfamethoxazole. This study demonstrates the excellent activity of tigecycline against the increasingly encountered MDR bacteria in Lebanon. The introduction of this effective and viable drug for the initial or recommended treatment of serious infections caused by such highly resistant pathogens is an asset for patients in this country and elsewhere. © 2008 Elsevier Inc. All rights reserved.ARAJ GF, 2000, LEBAN MED J, V48, P221; Babinchak T, 2005, CLIN INFECT DIS, V41, pS354, DOI 10.1086-431676; Betriu C, 2002, ANTIMICROB AGENTS CH, V46, P892, DOI 10.1128-AAC.46.3.892-895.2002; Biedenbach DJ, 2001, DIAGN MICR INFEC DIS, V40, P173, DOI 10.1016-S0732-8893(01)00269-3; Bouchillon SK, 2005, DIAGN MICR INFEC DIS, V52, P173, DOI 10.1016-j.diagmicrobio.2005.06.004; Castanheira M, 2008, ANTIMICROB AGENTS CH, V52, P570, DOI 10.1128-AAC.01114-07; *CLSI, 2006, M100S16 CLSI CLSI; Curcio D, 2007, J ANTIMICROB CHEMOTH, V60, P449, DOI 10.1093-jac-dkm202; Ellis-Grosse EJ, 2005, CLIN INFECT DIS, V41, pS341, DOI 10.1086-431675; Fraise AP, 2006, J INFECTION, V53, P293, DOI 10.1016-j.jinf.2006.05.014; Fritsche TR, 2005, DIAGN MICR INFEC DIS, V52, P195, DOI 10.1016-j.diagmicrobio.2005.05.003; Gales AC, 2000, DIAGN MICR INFEC DIS, V36, P19, DOI 10.1016-S0732-8893(99)00092-9; Hoban DJ, 2005, DIAGN MICR INFEC DIS, V52, P215, DOI 10.1016-j.diagmicrobio.2005.06.001; Jones RN, 2007, J CLIN MICROBIOL, V45, P227, DOI 10.1128-JCM.01588-06; Kanafani ZA, 2005, AM J INFECT CONTROL, V33, P326, DOI 10.1016-j.ajic.2005.03.009; Li J, 2007, CLIN INFECT DIS, V45, P594, DOI 10.1086-520658; Livermore DM, 2005, J ANTIMICROB CHEMOTH, V56, P611, DOI 10.1093-jac-dki291; Milatovic D, 2003, ANTIMICROB AGENTS CH, V47, P400, DOI 10.1128-AAC.47.1.400-404.2003; Murray PR, 2003, MANUAL CLIN MICROBIO; Neuhauser MM, 2003, JAMA-J AM MED ASSOC, V289, P885, DOI 10.1001-jama.289.7.885; Noskin GA, 2005, CLIN INFECT DIS, V41, pS303, DOI 10.1086-431672; Pachon-Ibanez ME, 2004, ANTIMICROB AGENTS CH, V48, P4479, DOI 10.1128-AAC.48.11.4479-4481.2004; PEREZ F, 2007, ANTIMICROB AGENTS CH, P3471; Reid GE, 2007, PHARMACOTHERAPY, V27, P1198, DOI 10.1592-phco.27.8.1198; Reynolds R, 2004, J ANTIMICROB CHEMOTH, V53, P1018, DOI 10.1093-jac-dkh232; Sader HS, 2005, DIAGN MICR INFEC DIS, V52, P181, DOI 10.1016-j.diagmicrobio.2005.05.005; Samaha-Kfoury JN, 2003, BRIT MED J, V327, P1209, DOI 10.1136-bmj.327.7425.1209; Samaha-Kfoury JN, 2005, AM J INFECT CONTROL, V33, P134, DOI 10.1016-j.ajic.2004.10.006; Schafer JJ, 2007, PHARMACOTHERAPY, V27, P980, DOI 10.1592-phco.27.7.980; Stein GE, 2006, CLIN INFECT DIS, V43, P518, DOI 10.1086-505494; Tan TY, 2007, ANN ACAD MED SINGAP, V36, P807; Tiengrim Surapee, 2006, J Med Assoc Thai, V89 Suppl 5, pS102; Vouillamoz J, 2008, J ANTIMICROB CHEMOTH, V61, P371, DOI 10.1093-jac-dkm459; Waites KB, 2006, ANTIMICROB AGENTS CH, V50, P3479, DOI 10.1128-AAC.00210-06; *WYETH PHARM, 2005, TIG TIG PROD INS; Zhang YY, 2004, DIAGN MICR INFEC DIS, V50, P267, DOI 10.1016-j.diagmicrobio.2004.08.007; Zinner SH, 2005, CLIN INFECT DIS, V41, pS289, DOI 10.1086-43167053
Epidemiology and risk factors for extended-spectrum β-lactamase- producing organisms: A case control study at a tertiary care center in Lebanon
No full textBackground: Infections caused by extended-spectrum β-lactamase (ESBL)-producing gram-negative bacilli constitute a growing problem worldwide. At the American University of Beirut Medical Center (AUBMC), we have observed a significant rise in the rates of ESBL-producing organisms over the past 5 years. Methods: Using a case control study design, we compared 99 patients with infections caused by ESBL-producing Escherichia coli and Klebsiella species and 99 frequency-matched controls from which ESBL-nonproducing isolates were recovered at AUBMC. Results: The most notable risk factor for acquiring infections with ESBL-producing organisms was antibiotic consumption within 30 days of the infection (OR, 7.06; 95percent CI: 3.27-15.24), with third-generation cephalosporins being associated with the highest risk (OR, 28.4; 95percent CI: 3.7-215.8). Other risk factors included recent surgery, presence of a urinary catheter, and need for mechanical ventilation. Moreover, cases had a longer mean duration of hospitalization and were more likely to have relapse of their infection than controls. Conclusions: Recent antibiotic use is by far the most important predisposing factor to infection with ESBL-producing organisms. Such infections are associated with prolonged hospital stay and increased morbidity. Attention should be redirected toward the unjustified liberal use of broad-spectrum antibiotics both in the hospital and in the community. Copyright © 2005 by the Association for Professionals in Infection Control and Epidemiology, Inc.Araj G F, 2000, J Med Liban, V48, P221; Colodner R, 2004, EUR J CLIN MICROBIOL, V23, P163, DOI 10.1007-s10096-003-1084-2; Daoud Z, 2003, Rev Esp Quimioter, V16, P233; Du B, 2002, INTENS CARE MED, V28, P1718, DOI 10.1007-s00134-002-1521-1; Goossens H, 2000, J ANTIMICROB CHEMOTH, V46, P39, DOI 10.1093-jac-46.suppl_2.39; Gupta A, 2004, INFECT CONT HOSP EP, V25, P210, DOI 10.1086-502380; Hamze Monzer, 2003, Sante, V13, P107; Hellinger WC, 2000, SOUTHERN MED J, V93, P842; Ho PL, 2002, SCAND J INFECT DIS, V34, P567, DOI 10.1080-00365540210147516; Kim BN, 2002, J HOSP INFECT, V52, P99, DOI 10.1053-jhin.2002.1288; Kim YK, 2002, ANTIMICROB AGENTS CH, V46, P1481, DOI 10.1128-AAC.46.5.1481-1491.2002; Kollef MH, 1999, CHEST, V115, P462, DOI 10.1378-chest.115.2.462; Lautenbach E, 2001, CLIN INFECT DIS, V32, P1162, DOI 10.1086-319757; Lucet JC, 1996, CLIN INFECT DIS, V22, P430; Mangeney N, 2000, J APPL MICROBIOL, V88, P504, DOI 10.1046-j.1365-2672.2000.00989.x; Mathur P, 2002, INDIAN J MED RES, V115, P153; Menashe G, 2001, SCAND J INFECT DIS, V33, P188, DOI 10.1080-00365540151060806; MEYER KS, 1993, ANN INTERN MED, V119, P353; *NAT COMM CLIN LAB, 2002, M100S12 NAT COMM CLI; NAUMOVSKI L, 1992, ANTIMICROB AGENTS CH, V36, P1991; Paterson DL, 2004, ANN INTERN MED, V140, P26; Paterson DL, 1999, CLIN INFECT DIS, V29, P1419, DOI 10.1086-313559; Paterson DL, 2001, J CLIN MICROBIOL, V39, P2206, DOI 10.1128-JCM.39.6.2206-2212.2001; Piroth L, 1998, CLIN INFECT DIS, V27, P76, DOI 10.1086-514643; QUINN JP, 1994, EUR J CLIN MICROB S1, V13, P539; Rebuck JA, 2000, CLIN INFECT DIS, V31, P1368, DOI 10.1086-317474; RICE LB, 1996, CLIN INFECT DIS, V23, P1184; RICE LB, 1990, ANTIMICROB AGENTS CH, V34, P2193; Rodriguez-Bano J, 2004, J CLIN MICROBIOL, V42, P1089, DOI 10.1128-JCM.42.3.1089-1094.2004; Samaha-Kfoury JN, 2003, BRIT MED J, V327, P1209, DOI 10.1136-bmj.327.7425.1209; Samaha-Kfoury JN, 2005, AM J INFECT CONTROL, V33, P134, DOI 10.1016-j.ajic.2004.10.006; Saurina G, 2000, J ANTIMICROB CHEMOTH, V45, P895, DOI 10.1093-jac-45.6.895; Schiappa DA, 1996, J INFECT DIS, V174, P529; Tenover FC, 1999, J CLIN MICROBIOL, V37, P4065; Wiener J, 1999, JAMA-J AM MED ASSOC, V281, P517, DOI 10.1001-jama.281.6.517; Wong-Beringer A, 2001, PHARMACOTHERAPY, V21, P583, DOI 10.1592-phco.21.6.583.3453726252
