30 research outputs found
Characterization of OXA-181, a Carbapenem-Hydrolyzing Class D β-Lactamase from Klebsiella pneumoniae
No full textABSTRACT
Klebsiella pneumoniae
KP3 was isolated from a patient transferred from India to the Sultanate of Oman.
K. pneumoniae
KP3 was resistant to all β-lactams, including carbapenems, and expressed the carbapenem-hydrolyzing β-lactamase OXA-181, which differs from OXA-48 by four amino acid substitutions. Compared to OXA-48, OXA-181 possessed a very similar hydrolytic profile. The
bla
OXA-181
gene was located on a 7.6-kb ColE-type plasmid and was linked to the insertion sequence IS
Ecp1
. The IS
Ecp1
-mediated one-ended transposition of
bla
OXA-181
was also demonstrated.
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An Unusual Presentation of Double-Outlet Right Atrium
No full text\ua9 The Author(s) 2024.We describe an unusual example of double-outlet right atrium with separate atrioventricular junctions. The straddling and overriding tricuspid valve had two orifices, and the mitral valve was morphologically normal. An appropriate understanding of the morphology of the atrioventricular junctions, the valves, and the subvalvar apparatus, along with the location of the atrioventricular conduction axis, allowed for successful biventricular repair
Rates of central line–associated bloodstream infection in tertiary care hospitals in 3 Arabian gulf countries: 6-year surveillance study
No full textIdentifying Anomalies of Systemic Venous Drainage: Systemic Venous Anomalies; Atrial Morphology
No full text\ua9 The Author(s) 2023.So as to produce totally anomalous systemic venous connection, all of the systemic venous tributaries, along with the coronary sinus, should be connected with the morphologically left atrium. Previous descriptions of this rare constellation of anomalous connections of the systemic venous tributaries of the heart have been compromised by the inclusion of individuals having isomeric atrial appendages. In these settings, most frequently, the totally, or almost totally, anomalous systemic venous connections are associated with a sinus venosus defect. It is the anomalous pulmonary venous connections that then create a venovenous bridge, which permits the systemic venous tributaries to drain into the morphologically left atrium, even though they may be predominantly connected to the right atrium. More rarely, it is feasible for the primary atrial septum to develop so as to leave the systemic venous sinus in direct connection with the body of the morphologically left, rather than the morphologically right, atrium. We report a series of patients potentially falling into the category of anomalous systemic venous connections. The findings show a spectrum from partially to totally anomalous connections, with some better interpreted on the basis of anomalous drainage. Included in our cases, nonetheless, is an autopsied example of totally anomalous systemic venous connection produced by an abnormal location of the primary atrial septum. We discuss the potential morphogenesis for this finding. We emphasize the distinction that needs to be made between anomalous systemic venous connections and anomalous systemic venous drainage
Persistence of SARS-CoV-2 Antibody Response across Diverse Clinical Settings in Oman: Insights from a Prospective ELISA-based Study
No full textObjectives: The durability of SARS-CoV-2 antibody response varies with disease severity [1]. Comparative data across diverse clinical settings in the Gulf region are limited. This study assessed the persistence of SARS-CoV-2 immunoglobulin G (IgG) antibodies over 6 months among hospitalized patients, outpatients, and healthcare workers (HCWs). Methods: In this prospective cohort study, 356 confirmed COVID-19 cases (123 inpatients, 113 outpatients, and 120 HCWs) were enrolled. Serum IgG titers were measured using enzyme-linked immunosorbent assay (ELISA) at baseline (≤14 days post-symptom onset), 4-6 weeks, 3 months, and 6 months post-infection. Longitudinal antibody dynamics were analyzed using a linear mixed-effect model adjusting for patient group, age, comorbidities, and symptoms. Results: Inpatients were older, male, and had more comorbidities, including obesity 54.5% (67 of 123), diabetes mellitus 39% (48 of 123), and hypertension 39.8% (49 of 123), compared with outpatients and HCWs. Peak antibody titers were reached at 4-6 weeks, with gradual decline over the 6-month period after initial infection across all groups (P <0.001). Inpatients demonstrated significantly higher IgG titers at all time points (P <0.001). Conclusions: Severe COVID-19 infection, older age, and comorbidities were linked to stronger, more durable IgG responses. These findings provide essential baseline data on post–COVID-19 immunity in the Gulf region during early pandemic.</p
Prevalence of phonatory symptoms in patients with type 2 diabetes mellitus
No full textTo look at the prevalence of phonatory symptoms in patients with type 2 diabetes mellitus. The correlation between these symptoms with duration of the disease, glycemic control, and neuropathy will be described. A total of 105 consecutive patients diagnosed with type 2 diabetes mellitus by their primary endocrinologist were evaluated. A control group consisting of 33 healthy subjects was recruited for this study. Demographic data included: age, gender, allergy, smoking, duration of the disease, glycemic control, and presence or absence of neuropathy. Subjects were also asked about the presence or absence of the following symptoms: hoarseness, vocal tiring or fatigue, vocal straining, and aphonia or complete loss of voice. Patients were also asked to fill out the Voice Handicap Index 10. The mean age of patients with diabetes was 53.21 + 9.68 years with male-to-female ratio of 2-3. The most common phonatory symptoms were vocal tiring or fatigue and hoarseness (34.3 and 33.3 percent). There was a significant difference in the prevalence of hoarseness and vocal straining (p value 0.045 and 0.015, respectively) compared to controls. There was a significant correlation between glycemic control, neuropathy, and hoarseness (p value 0.030 and 0.001, respectively). Vocal straining and aphonia also correlated significantly with the presence of neuropathy. Close to 16 percent of diabetic patients had a VHI-10 above or equal to 7. Diabetic patients are more likely to have phonatory symptoms compared to controls, namely straining and hoarseness. One out of seven patients with diabetes has reported that phonatory symptoms had a significant impact on their quality of life. The presence of neuropathy and poor glycemic control should alert the treating physician to these vocal complaints. © 2012 Springer-Verlag.Al-Maskari MY, 2011, SAUDI MED J, V32, P1285; Arffa RE, J VOICE; Asad A, 2010, J PAK MED ASSOC, V60, P166; Boden G, 1996, DIABETES CARE, V19, P394, DOI 10.2337-diacare.19.4.394; Campbell NRC, 2011, CAN FAM PHYSICIAN, V57, P997; CDC, 2009, NAT DIAB FACT SHEET; Dabelea D, 1999, DIABETES CARE, V22, P944, DOI 10.2337-diacare.22.6.944; Expert Committee on the Diagnosis and Classification of Diabetes Mellitus, 2003, DIABETES CARE S1, V26, pS5, DOI DOI 10.2337-DIACARE.26.2007.S5; Gat-Yablonski Galia, 2006, Pediatr Endocrinol Rev, V3 Suppl 3, P514; Haffner SM, 1999, DIABETES CARE, V22, P562, DOI 10.2337-diacare.22.4.562; Holmkvist J, 2008, DIABETES, V57, P1738, DOI 10.2337-db06-1464; Ijzerman TH, 2011, MUSCLE NERVE, V44, P241, DOI 10.1002-mus.22039; Jackbson BH, 1997, AM J SPEECH-LANG PAT, V6, P66; Krishnan JA, 2010, DIABETES MED, V27, P977; Lewko J, 2007, Adv Med Sci, V52 Suppl 1, P144; National Eye Institute, 2009, DIAB EYE DIS FAQ PRE; National Institute of Diabetes and Digestive and Kidney Diseases, 2007, NAT DIAB STAT 2007; Perkins BA, 2010, DIABETIC MED, V27, P1271, DOI 10.1111-j.1464-5491.2010.03110.x; Rosen CA, 2004, LARYNGOSCOPE, V114, P1549, DOI 10.1097-00005537-200409000-00009; Sataloff RT, 1998, VOCAL HLTH PEDAGOGY, P97; Schunk M, 2011, DIABETIC MED, DOI [10.1111-j.1464-5491.2011.03465.x, DOI 10.1111-J.1464-5491.2011.03465.X.[]; Soe K, 2011, MATURITAS, V70, P151, DOI 10.1016-j.maturitas.2011.07.006; Stern MP, 1996, ANN INTERN MED, V124, P110; Van Acker K, 2009, DIABETES METAB, V35, P206, DOI 10.1016-j.diabet.2008.11.004; van Sloten TT, 2011, DIABETES RES CLIN PR, V91, P32, DOI 10.1016-j.diabres.2010.09.030; Welham NV, 2003, J VOICE, V17, P21, DOI 10.1016-S0892-1997(03)00033; Barba C, 2004, LANCET, V363, P157; Yarbrough DE, 1998, DIABETES CARE, V21, P1652, DOI 10.2337-diacare.21.10.16520
Prevalence and determinants of retinopathy in a cohort of Lebanese type II diabetic patients
No full textObjective: Our aim was to determine the prevalence and the risk factors for diabetic retinopathy (DR) in a cohort of type II diabetic patients in Lebanon. Design: Prospective observational cohort study. Participants: Five hundred consecutive patients with type II diabetes mellitus followed at the American University of Beirut Medical Center diabetes clinic were enrolled in the study. Methods: All patients 18 years or older with diabetes mellitus who did not have gestational diabetes and who were able to complete the laboratory data and the retinal examination were invited to participate in the study; they were followed up for a period of 3 years. Results: DR was present in 175 patients (35percent), 130 (26percent), and 45 (9percent) having nonproliferative and proliferative DR, respectively. Clinically significant macular edema was present in 42 patients (8percent). Microvascular and macrovascular diabetic complications, duration of disease, glycemic control, presence of hypertension (p 0.003), systolic blood pressure (p = 0.04), and insulin use (p 0.001) were individually significantly associated with a higher prevalence of DR on bivariate analysis. However, on multivariate regression analysis, only glycosylated hemoglobin 7percent (odds ratio [OR] 2.81, 95percent CI 1.06-7.43, p = 0.038), duration of diabetes (per 10 years, OR 9.0, 95percent CI 4.0-20.0, p 0.001), macroalbuminuria (OR 2.6, 95percent CI 1.14-5.96 p = 0.023), and systolic blood pressure (per 10 mm Hg, OR 1.27, 95percent CI 1.0-1.56, p = 0.037) were independent risk factors for DR. Conclusions: The elevated prevalence of DR in type II diabetic patients with high risk profiles calls for early medical intervention and education about DR and its identified controllable risk factors.Adler AI, 2000, BRIT MED J, V321, P412, DOI 10.1136-bmj.321.7258.412; Al-Maskari Fatma, 2007, BMC Ophthalmol, V7, P11, DOI 10.1186-1471-2415-7-11; Stearne MR, 1998, BRIT MED J, V317, P703; Choremis J, 2003, CAN J OPHTHALMOL, V38, P575; Dowse GK, 1998, AM J EPIDEMIOL, V147, P448; FERRIS FL, 1987, OPHTHALMOLOGY, V94, P761; Early Treatment Diabetic Retinopathy Study Research Group, 1991, OPHTHALMOLOGY, V98, P823; El-Asrar AM, 2002, INT OPHTHALMOLOGY, V24, P1; El-Asrar AMA, 1998, INT OPHTHALMOL, V22, P155, DOI 10.1023-A:1006240928938; El Haddad OAW, 1998, BRIT J OPHTHALMOL, V82, P901; Fong Donald S, 2003, Diabetes Care, V26 Suppl 1, pS99, DOI 10.2337-diacare.26.2007.S99; Girach A, 2006, J DIABETES COMPLICAT, V20, P228, DOI 10.1016-j.jdiacomp.2006.03.001; Herman WH, 1998, DIABETIC MED, V15, P1045, DOI 10.1002-(SICI)1096-9136(1998120)15:121045::AID-DIA6963.3.CO;2-C; Hirbli KI, 2005, DIABETES CARE, V28, P1262, DOI 10.2337-diacare.28.5.1262; KLEIN BEK, 1991, OPHTHALMOLOGY, V98, P1261; KLEIN R, 1991, DIABETES CARE, V14, P914, DOI 10.2337-diacare.14.10.914; KLEIN R, 1987, DIABETES CARE, V10, P633, DOI 10.2337-diacare.10.5.633; MITCHELL P, 1990, AUST NZ J OPHTHALMOL, V18, P13, DOI 10.1111-j.1442-9071.1990.tb00578.x; ORCHARD TJ, 1990, DIABETES, V39, P1116, DOI 10.2337-diabetes.39.9.1116; Rajala U, 2000, DIABETES CARE, V23, P957, DOI 10.2337-diacare.23.7.957; Rema M, 2005, INVEST OPHTH VIS SCI, V46, P2328, DOI 10.1167-iovs.05-0019; Taleb-Bendiab A, 2008, LECT NOTES BUS INF, V8, P3; Tapp RJ, 2003, DIABETES CARE, V26, P1731, DOI 10.2337-diacare.26.6.1731; SHAMOON H, 1993, NEW ENGL J MED, V329, P977; Turner RC, 1998, LANCET, V352, P837; van Leiden HA, 2002, DIABETES CARE, V25, P1320, DOI 10.2337-diacare.25.8.1320; Waked N, 2006, J FR OPHTALMOL, V29, P289, DOI 10.1016-S0181-5512(06)73785-867
Types of tobacco consumption and the oral microbiome in the United Arab Emirates Healthy Future (UAEHFS) Pilot Study
No full text© 2018, The Author(s). Cigarette smoking alters the oral microbiome; however, the effect of alternative tobacco products remains unclear. Middle Eastern tobacco products like dokha and shisha, are becoming globally widespread. We tested for the first time in a Middle Eastern population the hypothesis that different tobacco products impact the oral microbiome. The oral microbiome of 330 subjects from the United Arab Emirates Healthy Future Study was assessed by amplifying the bacterial 16S rRNA gene from mouthwash samples. Tobacco consumption was assessed using a structured questionnaire and further validated by urine cotinine levels. Oral microbiome overall structure and specific taxon abundances were compared, using PERMANOVA and DESeq analyses respectively. Our results show that overall microbial composition differs between smokers and nonsmokers (p = 0.0001). Use of cigarettes (p = 0.001) and dokha (p = 0.042) were associated with overall microbiome structure, while shisha use was not (p = 0.62). The abundance of multiple genera were significantly altered (enriched/depleted) in cigarette smokers; however, only Actinobacillus, Porphyromonas, Lautropia and Bifidobacterium abundances were significantly changed in dokha users whereas no genera were significantly altered in shisha smokers. For the first time, we show that smoking dokha is associated to oral microbiome dysbiosis, suggesting that it could have similar effects as smoking cigarettes on oral health
Incense Burning is Associated with Human Oral Microbiota Composition
No full text© 2019, The Author(s). Incense burning is common worldwide and produces environmental toxicants that may influence health; however, biologic effects have been little studied. In 303 Emirati adults, we tested the hypothesis that incense use is linked to compositional changes in the oral microbiota that can be potentially significant for health. The oral microbiota was assessed by amplification of the bacterial 16S rRNA gene from mouthwash samples. Frequency of incense use was ascertained through a questionnaire and examined in relation to overall oral microbiota composition (PERMANOVA analysis), and to specific taxon abundances, by negative binomial generalized linear models. We found that exposure to incense burning was associated with higher microbial diversity (p \u3c 0.013) and overall microbial compositional changes (PERMANOVA, p = 0.003). Our study also revealed that incense use was associated with significant changes in bacterial abundances (i.e. depletion of the dominant taxon Streptococcus), even in occasional users (once/week or less) implying that incense use impacts the oral microbiota even at low exposure levels. In summary, this first study suggests that incense burning alters the oral microbiota, potentially serving as an early biomarker of incense-related toxicities and related health consequences. Although a common indoor air pollutant, guidelines for control of incense use have yet to be developed
Health and wellbeing of staff working at higher education institutions globally during the post-COVID-19 pandemic period : evidence from a cross-sectional study
No full textBackground: The ongoing global crisis of Higher Education (HE) institutions during the post-COVID-19 pandemic period has increased the likelihood of enduring psychological stressors for staff. This study aimed to identify factors associated with job insecurity, burnout, psychological distress and coping amongst staff working at HE institutions globally. Methods: An anonymous cross-sectional study was conducted in 2023 with staff at HE institutions across 16 countries. Job insecurity was measured using the Job Insecurity Scale (JIS), burnout using the Perceived Burnout measure question, psychological distress using the Kessler Psychological Distress Scale (K10), and coping using the Brief Resilient Coping Scale. Multivariable logistic regression with a stepwise variable selection method was used to identify associations. Results: A total of 2,353 staff participated; the mean age (± SD) was 43(± 10) years and 61% were females. Most staff (85%) did not feel job insecurity, one-third (29%) perceived burnout in their jobs, more than two-thirds (73%) experienced moderate to very high levels of psychological distress, and more than half (58%) exhibited medium to high resilient coping. Perceived job insecurity was associated with staff working part-time [Adjusted Odds Ratio 1.53 (95% Confidence Intervals 1.15–2.02)], having an academic appointment [2.45 (1.78–3.27)], having multiple co-morbidities [1.86 (1.41–2.48)], perceived burnout [1.99 (1.54–2.56)] and moderate to very high level of psychological distress [1.68 (1.18–2.39)]. Perceived burnout was associated with being female [1.35 (1.12–1.63)], having multiple co-morbidities [1.53 (1.20–1.97)], perceived job insecurity [1.99 (1.55–2.57)], and moderate to very high levels of psychological distress [3.23 (2.42–4.30)]. Staff with multiple co-morbidities [1.46 (1.11–1.92)], mental health issues [2.73 (1.79–4.15)], perceived job insecurity [1.61 (1.13–2.30)], and perceived burnout [3.22 (2.41–4.31)] were associated with moderate to very high levels of psychological distress. Staff who perceived their mental health as good to excellent [3.36 (2.69–4.19)] were more likely to have medium to high resilient coping. Conclusions: Factors identified in this study should be considered in reviewing and updating current support strategies for staff at HE institutions across all countries to reduce stress and burnout and improve wellbeing. © The Author(s) 2024. **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliate “Muhammad Aziz Rahman, Pritmoy Das, Sheikh Alif, Masudus Salehin, Biswajit Banik, Bindu Joseph, Parul Parul, Andrew Lewis, Dixie Statham, Joanne Porter, Wendy Cross, Remco Polman” is provided in this record*
