METHODS: A retrospective cross-sectional evaluation of 1020 CXR radiographs from 2023 was performed. A quantitative classification approach was used to assess CXR for ACR and EC compliance, which included exposure, anatomical visibility, organ superimposition, and image annotation.
RESULTS: Only 15% of CXRs passed all of the quality standards. While exposure and anatomical visualization demonstrated adequate compliance, organ superimposition and image annotation were much lower, at 23% and 29%, respectively, revealing gaps that may impact diagnostic accuracy and patient safety.
CONCLUSION: Significant discrepancies in CXR quality highlight the need for enhanced training, rigorous adherence to imaging protocols, and robust quality control to improve diagnosis accuracy and patient outcomes, especially in expatriate screening programs.
METHODS: We undertook a narrative review of published papers among four WHO Regions including African and Asian countries. Relevant papers were sourced from 2018 to 2024 and synthesized by key stakeholder group, country, WHO Region, income level and year. The findings were summarized to identify pertinent future activities for all key stakeholder groups.
RESULTS: We sourced 459 papers, with a large number coming from Africa (42.7%). An appreciable number dealt with patients' KAP (33.1%), reflecting their influence on the prescribing and dispensing of antibiotics. There was marked consistency of findings among key stakeholder groups across the four WHO Regions, all showing concerns with high rates of prescribing of antibiotics for viral infections despite professed knowledge of antibiotics and AMR. There were similar issues among dispensers. Patients' beliefs regarding the effectiveness of antibiotics for self-limiting infectious diseases were a major challenge, although educational programmes did improve knowledge. The development of the AWaRe (Access, Watch and Reserve) system, including practical prescribing guidance, provides a future opportunity for the standardization of educational inputs.
CONCLUSIONS: Similar KAP regarding the prescribing and dispensing of antibiotics across LMICs and stakeholder groups presents clear opportunities for standardization of educational input and practical training programmes based on the AWaRe system.
AIM: To analyze trends in bacterial isolates and their antibiotic susceptibility patterns at Salmaniya Medical Complex from 2018 to 2023, with a specific focus on the impact of the COVID-19 pandemic on these trends.
METHODS: A retrospective analysis of microbiological data was conducted, covering the period from 2018 to 2023. The study included key bacterial pathogens such as Escherichia coli (E. coli), Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Staphylococcus aureus, among others. The antibiotic susceptibility profiles of these isolates were assessed using standard laboratory methods. To contextualize the findings, the findings were compared with similar studies from other regions, including China, India, Romania, Saudi Arabia, the United Arab Emirates, Malaysia, and United States.
RESULTS: The study revealed fluctuating trends in the prevalence of bacterial isolates, with notable changes during the COVID-19 pandemic. For example, a significant increase in the prevalence of Staphylococcus aureus was observed during the pandemic years, while the prevalence of E. coli showed a more variable pattern. Antibiotic resistance rates varied among the different pathogens, with a concerning rise in resistance to commonly used antibiotics, particularly among Klebsiella pneumoniae and E. coli. Additionally, the study identified an alarming increase in the prevalence of multidrug-resistant (MDR) strains, especially within Klebsiella pneumoniae and E. coli isolates. The impact of the COVID-19 pandemic on these trends was evident, with shifts in the frequency, resistance patterns, and the emergence of MDR bacteria among several key pathogens.
CONCLUSION: This study highlights the dynamic nature of bacterial isolates and their antibiotic susceptibility patterns at Salmaniya Medical Complex, particularly in the context of the COVID-19 pandemic. The findings underscore the need for continuous monitoring and effective anti-microbial stewardship programs to combat the evolving threat of antibiotic resistance. Further research and policy initiatives are required to address the identified challenges and improve patient outcomes in the face of these ongoing challenges.
METHODS: Periodontal pocket samples were obtained from 32 geriatrics who were chosen randomly from health clinics. Clinical periodontal parameters were recorded during the oral examination. Samples were subjected to DNA extraction and polymerase chain reaction (PCR) amplification. The identification of P. gingivalis by PCR assay was determined based on the P. gingivalis 16S rRNA subunit amplification. Medical illnesses of patients were recorded. Mild cognitive impairment was diagnosed according to cognitive score assessment and daily function.
RESULTS: Approximately 90.63% (n=29) of geriatric patients had periodontitis. The presence of P. gingivalis was significantly associated with periodontal depth and clinical attachment loss (p = 0.037). The extension of periodontal disease, cognitive impairment status, and diabetes status are highly associated with P. gingivalis. Conclusion: Due to asymptomatic periodontal disease in the early phase, early screening of bacterial detection and oral public health awareness is crucial, especially among elderly groups who are smokers and diabetics. P. gingivalis infection is associated with worsening geriatric periodontitis. Adequate oral care and comorbidity control among geriatrics are indeed crucial to preventing disease progression. It is important to improve and modify the local diabetic checklist protocol for geriatric diabetic patients by incorporating oral health and oral microbiome assessments, as well as cognitive assessments.
METHODS: A retrospective analysis was conducted on 51 patients (23 with SFT and 28 with AM) confirmed by pathology. Clinical and MRI characteristics were assessed using t-tests and chi-square tests. Logistic regression analysis was performed to identify independent predictors, and receiver operating characteristic (ROC) curve analysis evaluated diagnostic performance. A nomogram integrating ADC values with conventional MRI features was developed and validated using calibration curves.
RESULTS: Significant differences in tumor shape, cystic necrosis, T1-weighted imaging and T2-weighted imaging signal intensities, and ADC values were observed between SFT and AM (p < 0.05). Logistic regression analysis confirmed these factors as independent predictors, with ADC demonstrating the highest diagnostic performance at an optimal cutoff value of 1.08 × 10-³ mm²/second. The ROC analysis showed that combining ADC with conventional MRI features improved diagnostic accuracy. The calibration curve demonstrated strong agreement between nomogram predictions and actual outcomes.
CONCLUSION: Integrating ADC values with clinical and MRI features provides a reliable method for differentiating intracranial SFT from AM. This approach enhances diagnostic precision, aiding in optimized clinical decision-making and surgical planning.
AIM: To assess the effectiveness of an abdominal vibration combined with walking exercise (AVCWE) programme compared to walking exercise (WE) and standard preparation regimens for bowel preparation in older patients with constipation.
METHODS: This three-arm randomised controlled trial involved 271 older patients with constipation scheduled for colonoscopy. Patients assigned to the AVCWE group were asked to walk independently for at least 5500 steps and received two cycles of moderate-intensity abdominal vibrations. Patients in the WE group were required to walk independently for at least 5500 steps, whereas patients in the control group received only the standard regimen. The primary outcome was the rate of adequate bowel preparation, defined as a total score of ≥ 6 on the Boston Bowel Preparation Scale.
RESULTS: The rate of adequate bowel preparation in the AVCWE group (92.2%) was significantly higher than in the WE group (78.9%) and the control group (60.4%) (p
IMPORTANCE: Sulfate-reducing bacteria (SRB) play essential roles in global sulfur and carbon cycling and are critical for bioremediation and anaerobic digestion processes. However, detailed studies on the genotypic and phenotypic responses of SRB under varying pH conditions are limited. This study addresses this gap by examining the pH-dependent genetic and metabolic adaptations of Oleidesulfovibrio alaskensis G20, revealing key mechanisms regulating hydrogenase and ATPase activities, cell division, and extracellular polymeric substance formation. These findings provide new insights into how SRB maintains pH homeostasis, showcasing their ability to survive and function in both acidic and alkaline environments. Furthermore, this study reveals critical genetic and phenotypic characteristics that will directly aid to engineer industrial effluent management systems, bioremediation, and dissolved heavy metal recovery. By elucidating the dynamic response of O. alaskensis G20 to varied pH environments, the research provides a foundation for enhancing the resilience and performance of SRB-based systems, paving the way for improved environmental and industrial applications.