Theoretical estimation of the thermal damages of living tissues caused by laser irradiation in tumor thermal therapy

This article aims to provide theoretical predictions for the thermal reactions of human tissues during tumor thermotherapy when exposed to laser irradiation and an external heat source. For the construction of a theoretical study of bioheat transfer, the selection of a suitable thermal model capable of accurately predicting the required thermal responses is essential. The effect of heat production by heat treatment on a spherical multilayer tumor tissue is evaluated using this approach. Analytical solution for the non-homogenous differential equations is derived in the Laplace domain. The study examines the impact of thermal relaxation time on tissue temperature and the subsequent thermal damage. The numerical findings of thermal damage and temperatures are depicted in a graphical representation. This model explains laser treatment, physical events, metabolic support, and blood perfusion. The numerical outcomes of the recommended model are validated by comparing them to the literatures.

Cross-sectional community-based study to assess the awareness of toxoplasmosis in Saudi Arabia

A few reports have been published and documented low level of awareness on toxoplasmosis among Saudi women. Herein, a cross sectional community based study was undertaken to evaluate basic knowledge on toxoplasmosis among residents in the Eastern province (Sharqiyah). Thisstudy was conducted between December 2022 and January 2023 on 334 females from different ages and educational backgrounds. Analysis of their responses revealed that only (24.9%) had heard about the disease. However, (69.8%) properly identified cats as the source of Toxoplasma gondii (T. gondii), but a smaller percentage (47.7%) knew that they might become infected through handling cat feces, and a few (26.3%) believed that bad hand hygiene can result in T. gondii infection. A few males (n = 26) have also participated, for the first time in Saudi Arabia, and displayed also low level of knowledge on toxoplasmosis. We do recommend establishing educational programs for females, in various Saudi provinces, to raise awareness on toxoplasmosis.

Tick-borne pathogens in camels: A systematic review and meta-analysis of the prevalence in dromedaries

Published data on tick-borne pathogens (TBPs) in camels worldwide have been collected to provide an overview of the global prevalence and species diversity of camelid TBPs. Several TBPs have been detected in dromedary camels, raising concerns regarding their role as natural or maintenance hosts for tick-borne pathogens. Insubstantial evidence exists regarding the natural infection of camels with Babesia spp., Theileria spp., Anaplasma spp., and Ehrlichia spp., particularly because most of the camels were considered healthy at the time of sampling. Based on polymerase chain reaction (PCR) testing, a pooled prevalence of 35.3% (95% CI: 22.6-48.1%) was estimated for Anaplasma, which was the most frequently tested TBP in dromedaries, and DNA of Anaplasma marginale, Anaplasma centrale, Anaplasma ovis, Anaplasma platys, and A. platys-like were isolated, of which ruminants and dogs are reservoirs. Similarly, the estimated pooled prevalence for the two piroplasmid genera; Babesia and Theileria was approximately equal (10-12%) regardless of the detection method (microscopy or PCR testing). Nevertheless, Babesia caballi, Theileria equi, and Theileria annulata DNA have frequently been detected in camels but they have not yet been proven to be natural hosts. Scarce data detected Babesia microti, Anaplasma phagocytophilum, and Borrelia burgdorferi sensu lato (s.l.) DNA in blood of dromedaries, although ticks of the genus Ixodes are distributed in limited areas where dromedaries are raised. Interestingly, a pooled seroprevalence of 47.7% (26.3-69.2%) was estimated for Crimean-Congo hemorrhagic fever virus, and viral RNA was detected in dromedary blood; however, their contribution to maintain the viral transmission cycles requires further experimental investigation. The substantially low incidence and scarcity of data on Rickettsia and Ehrlichia species could imply that camels were accidentally infected. In contrast, camels may play a role in the spread of Coxiella burnetii, which is primarily transmitted through the inhalation of aerosols emitted by diseased animals and contaminated environments. Bactrian camels showed no symptoms due to the examined TBPs, meanwhile, clinical disease was seen in alpacas infected with A. phagocytophilum. Similar to dromedaries, accidental tick bites may be the cause of TBP DNA found in the blood of Bactrian camels.

Influence of thermal relaxation time on thermomechanical interactions in biological tissue during hyperthermia treatment

This study presents an analytical analysis of thermo-mechanical interactions within living tissues using a generalized biothermoelastic model with one thermal relaxation time. Utilizing Laplace transforms and associated techniques, we investigate the response of living tissue to a pulse boundary heat flux that decays exponentially on a traction-free surface. Through detailed graphical illustrations, we elucidate the influence of key parameters such as thermal relaxation time, blood perfusion rate, and the characteristic time of the pulsing heat flux on temperature distribution, displacement, and thermal strain. Our results are presented through comprehensive graphical representations. Furthermore, a parametric analysis is conducted to guide the selection of optimal design factors, enhancing the accuracy of hyperthermia treatments.

Genetic Diversity of Merozoite Surface Antigens in Global Babesia bovis Populations

Cattle can be severely infected with the tick-borne protozoa Babesia bovis, giving rise to serious economic losses. Invasion of the host's RBCs by the parasite merozoite/sporozoites depends largely on the MSA (merozoite surface antigens) gene family, which comprises various fragments, e.g., MSA-1, MSA-2a1, MSA-2a2, MSA-2b and MSA-2c, highlighting the importance of these antigens as vaccine candidates. However, experimental trials documented the failure of some developed MSA-based vaccines to fully protect animals from B. bovis infection. One reason for this failure may be related to the genetic structure of the parasite. In the present study, all MSA-sequenced B. bovis isolates on the GenBank were collected and subjected to various analyses to evaluate their genetic diversity and population structure. The analyses were conducted on 199 MSA-1, 24 MSA-2a1, 193 MSA-2b and 148 MSA-2c isolates from geographically diverse regions. All these fragments displayed high nucleotide and haplotype diversities, but the MSA-1 was the most hypervariable and had the lowest inter- and intra-population gene flow values. This fragment also displayed a strong positive selection when testing its isolates for the natural selection, which suggests the potential occurrence of more genetic variations. On the contrary, the MSA-2c was the most conserved in comparison to the other fragments, and displayed the highest inter- and intra-population gene flow values, which was evidenced by a significantly negative selection and negative neutrality indices (Fu's Fs and Tajima's D). The majority of the MSA-2c tested isolates had two conserved amino acid repeats, and earlier reports have found these repeats to be highly immunogenic, which underlines the importance of this fragment in developing vaccines against B. bovis. Results of the MSA-2a1 analyses were also promising, but many more MSA-2a1 sequenced isolates are required to validating this assumption. The genetic analyses conducted for the MSA-2b fragment displayed borderline values when compared to the other fragments.

Evaluating a novel patient pathway to manage symptomatic breast referrals (the blue flag clinic): a longitudinal observational study

INTRODUCTION

A novel referral pathway for exhibited breast symptom (EBS) referrals to manage increasing referrals of urgent suspected cancer (USC) was implemented in our trust. We report on the safety and effect on compliance with the 2-week-wait rule (2WW).

METHODS

A single-centre longitudinal observational study included all patients referred to a UK breast unit during 13 May 2019 to 27 March 2020 (period 1) and 8 February 2021 to 31 January 2022 (period 2). USC referrals were assessed in a one-stop clinic (red flag clinic [RFC]); EBS referrals were assessed in a new clinic in which clinical evaluation was performed and imaging occurred subsequently (blue flag clinic [BFC]). Patients were followed up to determine the symptomatic interval cancer rate.

RESULTS

There were 9,695 referrals; 1,655 referrals (17%) were assessed in the BFC after 63 exclusions. Some 95.9% of patients had a benign clinical examination (P1/P2), 80.1% had imaging (mammogram or ultrasound) and 4% had a tissue biopsy. In total, 16/1,655 (0.97%) BFC patients and 510/7,977 (8.2%) RFC patients were diagnosed with breast cancer (breast cancer detection rate). Some 1,631 patients (with 1,639 referrals) were discharged and followed up for a median of 17 months (interquartile range 12-32) with one subsequent cancer diagnosis (symptomatic interval cancer rate, 0.06%). Implementation of the BFC pathway increased 3-month average trust performance of USC referrals with 2WW standard from 8.5% to 98.7% (period 1) and from 30% to 66% (period 2).

CONCLUSIONS

The BFC pathway for EBS patients is safe and implementation led to improvement against the 2WW target for USC referrals, ensuring resources are prioritised to patients with the highest likelihood of breast cancer.

Global prevalence and species diversity of tick-borne pathogens in buffaloes worldwide: a systematic review and meta-analysis

BACKGROUND

Buffaloes are important contributors to the livestock economy in many countries, particularly in Asia, and tick-borne pathogens (TBPs) commonly infect buffaloes, giving rise to serious pathologies other than their zoonotic potential.

METHODS

The present investigation focuses on the prevalence of TBPs infecting buffaloes worldwide. All published global data on TBPs in buffaloes were collected from different databases (e.g., PubMed, Scopus, ScienceDirect, and Google Scholar) and subjected to various meta-analyses using OpenMeta[Analyst] software, and all analyses were conducted based on a 95% confidence interval.

RESULTS

Over 100 articles discussing the prevalence and species diversity of TBPs in buffaloes were retrieved. Most of these reports focused on water buffaloes (Bubalus bubalis), whereas a few reports on TBPs in African buffaloes (Syncerus caffer) had been published. The pooled global prevalence of the apicomplexan parasites Babesia and Theileria, as well as the bacterial pathogens Anaplasma, Coxiella burnetii, Borrelia, Bartonella, and Ehrlichia in addition to Crimean-Congo hemorrhagic fever virus, were all evaluated based on the detection methods and 95% confidence intervals. Interestingly, no Rickettsia spp. were detected in buffaloes with scarce data. TBPs of buffaloes displayed a fairly high species diversity, which underlines the high infection risk to other animals, especially cattle. Babesia bovis, B. bigemina, B. orientalis, B. occultans and B. naoakii, Theileria annulata, T. orientalis complex (orientalis/sergenti/buffeli), T. parva, T. mutans, T. sinensis, T. velifera, T. lestoquardi-like, T. taurotragi, T. sp. (buffalo) and T. ovis, and Anaplasma marginale, A. centrale, A. platys, A. platys-like and "Candidatus Anaplasma boleense" were all were identified from naturally infected buffaloes.

CONCLUSIONS

Several important aspects were highlighted for the status of TBPs, which have serious economic implications for the buffalo as well as cattle industries, particularly in Asian and African countries, which should aid in the development and implementation of prevention and control methods for veterinary care practitioners, and animal owners.

Gastrointestinal parasites of cats in Egypt: high prevalence high zoonotic risk

BACKGROUND

Several gastrointestinal parasites that infect cats pose potential health threats for humans and animals. The present study is the first to report gastrointestinal (GIT) parasites in feces of stray cats from Gharbia governorate, Egypt. Findings were combined with those published in the earlier surveys from various Egyptian governorates, and various meta-analyses were conducted to underline the parasitic zoonoses from cats in Egypt.

RESULTS

Out of 143 samples tested in Gharbia, 75 (52.4%) were found infected with 13 different parasites. Co-infections were observed in 49.3% of positives. Several parasites were detected, e.g., Toxocara cati (30.0%), Toxascaris leonina (22.4%), hookworms (8.4%), taeniids (4.2%), Strongyloides spp. (2.1%), Physaloptera spp. (2.1%), Alaria spp. (1.4%) and Dipylidium caninum (0.7%). Opisthorchis-like eggs were found in a single sample being the first report from cats in Africa. Oocysts of 4 coccidian parasites were identified, and a few Toxoplasma gondii-like oocysts were detected in 2 samples (1.4%). Results of the meta-analysis illustrated that occurrence of T. gondii oocysts in feces of cats from Egypt may have been overestimated in earlier studies; 1432 cats have been tested and displayed a 5 times higher pooled prevalence (11.9%) than the published global pooled prevalence for T. gondii oocysts in cats. This overestimation might have occurred because some small-sized oocysts that belong to other coccidian parasites were mis-identified as T. gondii. Toxocara cati had a high pooled prevalence (22.5%) in cats from Egypt, which is even greater than the published pooled prevalence in cats globally; however, several reports from Egypt have neglected the role of T. cati in human toxocarosis. Dipylidium caninum displayed also a high prevalence (26.7%).

CONCLUSION

Several zoonotic parasite species have been found in stray cats from Egypt, raising concerns about the risks to the Egyptian human population as well as environmental contamination. Prompt surveillance supervised by the government and accompanied by data dissemination will be helpful for developing effective control strategies.

Robot-mediated interventions for teaching children with ASD: A new intraverbal skill

Socially assistive robots (SAR) have the potential to impact therapies for Autism Spectrum Disorder (ASD) by supporting clinicians in increasing learning opportunities presented to individuals. Recent research on robot-mediated intervention (RMI) delivery has predominantly addressed social deficits in ASD with positive outcomes. Current literature has minimal focus on teaching children with ASD a skill not known apriori by the individual. Furthermore, it is unclear how to integrate robots in clinical settings because current RMIs do not adhere to Applied Behavior Analysis (ABA) protocols. In this work, we investigated whether an RMI could be utilized to teach children with ASD a completely new language and communication skill they could not exhibit at baseline. We utilized a standard ABA assessment tool to first identify appropriate skills to teach children with ASD. We then developed, implemented, and evaluated an RMI intervention that followed standard clinical operating procedures in ABA and targets participants' unique skill deficits. We examined the effects of the RMI training on teaching wh-question answering. All sessions were conducted with the SAR as the primary therapist using evidenced-based ABA human teaching protocols. All participants acquired the wh-questions answering skill within seven sessions, which is in line with their typical acquisition rates.

Global epidemiology and molecular biology of Taenia multiceps: a comparative meta-analysis and in silico analysis study

In the present study, all published data on the epidemiology and molecular characters of Taenia multiceps were systematically collected from relevant databases (e.g. PubMed, Scopus, National Center for Biotechnology Information), and combined in various statistical and genetic analyses as a contribution to a better understanding of the epidemiology of this ubiquitous taeniid worldwide. While 5.8% of the key hosts (dogs) from various countries had T. multiceps, grey wolves displayed the highest prevalence (21.6%) among the definitive hosts. Small ruminants are the main intermediate hosts and carry the coenuri in various locations, but most commonly in the central nervous system (CNS). Cerebral coenuri were confirmed in 53% of sheep exhibiting neurological symptoms, and infected animals often had only a single coenurus in the brain. Sheep had a higher prevalence (8.8%) of CNS coenuri than goats (5.8%); however, extra-CNS coenuri were detected more frequently in goats than in sheep. In either case, the difference between sheep and goats was statistically insignificant. Analysis of 233 partial cytochrome oxidase subunit I nucleotide sections for T. multiceps revealed high haplotype and low nucleotide diversities. Fifty-one haplotypes were detected circulating in 6 geographic populations. China, Iran and Turkey had 2 major haplotypes, whereas Italy and Egypt shared 3. Haplotypes from Greece circulate worldwide, and displayed similar gene flow values when compared with the other populations. There were no distinct patterns for haplotype distribution in relation to the infected hosts or coenuri locations. The existence of genetic variants in T. multiceps was highlighted, but needs further studies.

Trichostrongyle infections in domestic ruminants from Egypt: A systematic review and meta-analysis

Trichostrongylid nematodes can cause serious loss in the livestock economy; nevertheless, infections with these ubiquitous nematodes in animals from developing countries are largely neglected. The present paper provides a systematic review and meta-analysis to evaluate the status of trichostrongyle infections in domestic ruminants from Egypt. Out of 626 collected publications, 118 were defined suitable for inclusion in this review and represented trichostrongyle infections in 5 ruminant species (sheep, goats, cattle, buffaloes and camels) from Egypt. Published surveys have mostly focused on sheep, which had the highest (44.8%) pooled prevalence of trichostrongyle infections based on 95% confidence interval (35.9-53.6%) with no significant variations among sheep in different Egyptian regions. Goats had lower infection prevalence (31.2%, 21.5-40.8%) in comparison to sheep, and no significant regional differences were also found. The management and marketing practices likely account for the wide distribution of infection among small ruminants across Egypt. Variable trichostrongyle infection rates were estimated for camels (38.8%, 28.9-48.7%), cattle (27.4%, 14.4-40.3%) and buffaloes (12.2%, 8.0-16.4%). The prevalence of infection was significantly high during winter (52.1%, 32.2-72.1%), which provide favorable conditions for development and survival of larvae on pastures. The most common trichostrongyle identified in infected animals was Haemonchus contortus. The parasite was detected in 38.8% (29.9-47.6%) of infected sheep, 35.3% (24.8-45.7%) of infected goats and in 40.6% (18.6-62.5%) of infected camels. Clinical infections have been reported in a limited number of studies. Analysis of fecal egg counts (FECs) revealed that more than half (52.7%, 30.4-75.0%) of the tested sheep had low counts (<500 eggs per gram EPG), whereas only a few sheep (6.1%, 3.5-8.7%) had high counts >2000 EPG, implying that subclinical infections are common; however, the clinical infections cannot be completely ruled out. Anthelmintic resistance does not appear to be serious in trichostrongyle populations infecting ruminants from Egypt; nonetheless there have been a few cases of albendazole resistance in trichostrongyles infecting sheep. This paper contributes to a better understanding of the epidemiology and economic implications of trichostrongyle infections in ruminants from Egypt, which is crucial for establishing effective control strategies against these ubiquitous nematodes.

Molecular Epidemiology and Species Diversity of Tick-Borne Pathogens of Animals in Egypt: A Systematic Review and Meta-Analysis

Ticks and tick-borne pathogens (TTBPs) are listed among the most serious concerns harming Egyptian livestock’s productivity. Several reports on tick-borne pathogens (TBPs) from various geographical regions in the country were published. However, data on the molecular characterization of TBPs are the most beneficial for understanding the epidemiology of this important group of pathogens. In this study, we present the first meta-analysis on the molecular epidemiology and species diversity of TBPs infecting animals in Egypt. All published studies on TBPs were systematically collected from various databases (PubMed, Scopus, ScienceDirect, the Egyptian Knowledge Bank, and Google Scholar). Data from eligible papers were extracted and subjected to various analyses. Seventy-eight studies were found to be eligible for inclusion. Furthermore, ticks infesting animals that were molecularly screened for their associated pathogens were also included in this study to display high species diversity and underline the high infection risk to animals. Theileria annulata was used as parasite model of TBPs to study the genetic diversity and transmission dynamics across different governorates of Egypt. This study extends cross-comparisons between all published molecular data on TBPs in Egypt and provides resources from Egyptian data in order to better understand parasite epidemiology, species diversity, and disease outcome as well as the development and implementation of prevention and control methods for public health, veterinary care practitioners, and animal owners all over the country.

Analysis of Thermoelastic Interaction in a Polymeric Orthotropic Medium Using the Finite Element Method

In this work, the finite element technique is employed to evaluate the effects of thermal relaxation durations on temperature, displacements, and stresses in a two-dimensional, polymeric, orthotropic, elastic medium. The problem is considered in a homogeneous, polymeric, orthotropic medium in the context of the Green and Lindsay model with two thermal relaxation times. The bounding surface of the half-space was subjected to a heat flux with an exponentially decaying pulse. Finite element techniques were used to solve the governing formulations, with eight-node isoparametric rectangular elements with three degrees of freedom (DOF) per node. The developed method was calculated using numerical results applied to the polymeric, orthotropic medium. The findings were implemented and visually shown. Finally, the results were displayed to demonstrate the differences between classical dynamic coupling (CT), the Lord-Shulman (LS) and the Green and Lindsay (GL) models.

Cryptosporidium infection in humans and animals from Iraq: A review

The apicomplexan parasite Cryptosporidium causes serious diarrheal disease in humans and animals worldwide. The present review summarizes epidemiological and molecular studies as well as the clinical disease burden of natural Cryptosporidium infections in humans and animals from Iraq. Retrieved reports regarding cryptosporidiosis in Iraq indicated that the disease is highly prevalent in humans and animals, but the results extracted from these reports are confusing and mostly employed traditional methodologies for the detection of Cryptosporidium infective stage, the oocysts, in clinical samples. Many screened surveys represent point prevalence studies, which described diarrhea in infants and children due to cryptosporidiosis; however, other pathogens causing diarrhea were not excluded. High prevalence of Cryptosporidium oocysts was recovered from many studies from different environmental matrices in different parts of Iraq including drinking tap water, which facilitates its transmission to humans and animals. Reports on molecular characterization of different Cryptosporidium species which exist in Iraq are few but both Cryptosporidium hominis and Cryptosporidium parvum were detected in humans and the latter was more prevalent in isolates from cattle, sheep, goats and birds. A national study on adequate numbers of samples from different hosts and environmental matrices, and employing advanced diagnostic methodologies is required to precisely detect the epidemiological situation of cryptosporidiosis in Iraq. Furthermore, molecular genotyping studies are required to be conducted in Iraq to characterize the species and subtypes of Cryptosporidium infecting humans and animals especially during outbreaks. Therefore, Cryptosporidium parasite should be included in the routine diagnosis and surveillance system of infectious diseases in Iraq and should be regarded as an important public health problem of concern.

Molecular characterization of Cysticercus tenuicollis isolates from sheep in the Nile Delta, Egypt and a review on Taenia hydatigena infections worldwide

The predator–prey-transmitted cestode Taenia hydatigena infects a wide range of definitive and intermediate hosts all over the world. Domestic and sylvatic cycles of transmission are considered as well. The parasite has considerable economic importance, particularly in sheep. Here, the molecular characters of T. hydatigena cysticerci in sheep from the Nile Delta, Egypt were investigated for the first time. For this purpose, 200 sheep carcasses and their offal were inspected at the municipal abattoir, Dakahlia governorate, Egypt. Cysticerci of T. hydatigena were collected and molecularly characterized employing the mitochondrial 12S rRNA gene. Cysticerci were found in 42 (21%) sheep, mostly attached to the omenti, mesenteries and livers. After molecular confirmation, nine isolates were sequenced displaying six different haplotypes. Analysis of the T. hydatigena 12S rRNA nucleotide sequences deposited in GenBank revealed 55 haplotypes out of 69 isolates, displaying high haplotype (0.797) and low nucleotide (0.00739) diversities. For the Tajima D neutrality index, a negative value (−2.702) was determined, indicating the population expansion of the parasite. Additionally, global data summarized in this study should be useful to set up effective control strategies against this ubiquitous parasite.

Combined Molecular and Lectin Binding Assays to Identify Different Trichostrongyle Eggs in Feces of Sheep and Goats from Egypt

BACKGROUND

Trichostrongyles are common causes of parasitic gastroenteritis in sheep and goats worldwide. Accurate identification of these nematodes to the genus and/or species level is important for therapy selection and control strategies. In the present study, molecular and egg-lectin binding approaches were employed to identify the most economically important trichostrongyles circulating in sheep and goat herds from six districts in Dakahlia governorate, Egypt.

MATERIALS

Fecal samples from 653 and 205 goats reared within 17 herds were collected and tested for the trichostrongyle eggs using the modified Wisconsin sucrose flotation method. For identification of the trichostrongyle(s) present, eggs from 75 (63 sheep and 12 goats) samples which had high egg count (EPG) and pooled eggs (n = 19 pools, 15 sheep and 4 goats) from samples with moderate or low EPGs were examined. Molecular examination was conducted amplifying the ITS2 region of the rDNA for six different trichostrongyles in individual PCR reactions. For egg-lectin bindings, 4 fluorescently-labeled specific lectins were used; peanut agglutinin (PNA) for Haemonchus contortus, Aleuria aurantia agglutinin (AAL) for Trichostrongylus species, Lens culinaris agglutinin (LCA) for Teladorsagia circumcnicta and Lotus tetragonolobus lectin (LTL) for Cooperia species.

RESULTS

Fourteen (82.3%) herds were found infected, of which trichostrongyle eggs were detected in fecal samples of 26.5% (173/653) of sheep and 10.2% (21/205) of goats. Results of the PCR and lectin bindings were compatible and 4 trichostrongyles were detected: H. contortus, T. circumcincta, Trichostrongylus axei and Trichostrongylus colubriformis. Haemonchus contortus eggs were found in all the infected herds, and as the single species in 21 and 5 of sheep and goat samples, respectively. Lectin stained smears demonstrated the dominance of H. contortus eggs over eggs of the other detected trichostrongyles. Eleven herds were found infected with T. axei as the second most prevalent trichostrongyle; however, few AAL-stained eggs were noticed in the positive samples. Mixed infections were frequently detected as H. contortus-T. axei combination. Infections with T. circumcincta were noted in sheep samples from two herds, but not in any sample from the goats. No Ostertagia leptospicularis, Cooperia curticei or Nematodirus species were noted among the tested samples.

CONCLUSIONS

This is the first molecular and lectin binding survey to determine the species composition of trichostrongyles infecting sheep and goats from Egypt. Haemonchus contortus plays the principal role in small ruminant trichostrongylosis in Egypt. Egg-lectin staining shows promise for future for its application in routine diagnosis as a rapid and simple technique. Findings of the earlier reports from Egypt are tabulated and reviewed.

Triple lectin staining of trichostrongyle eggs from naturally infected small ruminants

Trichostrongyle nematodes can be a major threat to the profitability of small ruminant producers depending of the species and intensity of trichostrongyles parasitizing their herd. Haemonchus contortus, Teladorsagia circumcincta, and Trichostrongylus colubriformis are typically the most common and clinically important species. Three lectins (PNA, LCA and AAL) have been reported to bind specifically to eggs from these three genera and therefore could be used to quantify the intensity of each species in individual animals. Peanut agglutinin (PNA) has been the most commonly tested lectin because it selectively binds intensely to eggs of the most pathogenic species, H. contortus. Lens culinaris agglutinin (LCA) and Aleuria aurantia agglutinin (AAL) have shown specificity to T. circumcincta and Trichostrongylus spp. respectively, however, these lectins have only been evaluated using eggs harvested directly from adult females, and not from fecal samples. The purpose of the present study is to describe a method to sequentially stain H. contortus, T. circumcincta and Trichostrongylus spp. fecal eggs with PNA, LCA and AAL, and then evaluate the resultant staining patterns seen with eggs collected from a naturally infected goat shown with PCR to contain H. contortus, T. circumcincta, Ostertagia leptospicularis, Trichostrongylus colubriformis and Trichostrongylus axei eggs. These results were also compared with patterns observed with eggs stained with single lectins and double combinations of lectins. The various patterns were then compared to those seen with egg samples collected from an ewe shown to only contain H. contortus. PNA bound intensely and uniformly to all eggs from samples containing only H. contortus eggs; however, some eggs additionally bound LCA and AAL in localized patches of varying size, and a few eggs exhibited intense and uniform binding of all three lectins. Single PNA-staining of goat samples containing the five trichostrongyles species identified most eggs as H. contortus, and triple-staining showed patterns consistent with those seen for H. contortus. Binding of AAL to non-Haemonchus eggs was uniform but showed significant variations in intensity. Lesser staining eggs tended to also stain intensely with LCA, which is consistent with published binding pattern for T. circumcincta. Most eggs that AAL bound intensely to did not bind with LCA, which is consistent with published binding pattern for Trichostrongylus spp. Autofluorescence was observed with the DAPI filter-cube among most non-Haemonchus eggs. This study demonstrates the need for additional field studies to further validate the specificity of these three lectins for use in identifying eggs from the three species of trichostrongyles.

Molecular identification of different Trichostrongylus species infecting sheep and goats from Dakahlia governorate, Egypt

Nematodes of genus Trichostrongylus can cause remarkable economic losses in the small ruminant`s industry and some species have a zoonotic potential. Since the most common source for human infection is the infected animals, accurate identification of different Trichostrongylus species in animals would reflect the species that can infect humans from the same area. The objective of the present study is to identify common Trichostrongylus species infecting small ruminants in Dakahlia governorate, Egypt using molecular-based techniques. Fecal samples from 340 sheep and 115 goats from rural areas in 3 cities of Dakahlia governorate and 2 cities at its borders were collected, and the strongyle-type eggs were detected in 33.2% and 14.7% of sheep and goats, respectively. PCR amplification of the internal transcribed spacer of the ribosomal DNA (ITS2 rDNA) for 3 Trichostrongylus spp.; T. axei, T. colubriformis and T. vitrinus was conducted for eggs harvested from 25 sheep and 16 goat samples. Two species were detected; T. axei (in 16 sheep and 14 goats) and T. colubriformis (in 2 sheep but no goats). This is the first report of T. colubriformis in sheep from Dakahlia governorate, where this species was reported earlier from humans. No T. vitrinus was detected in any tested sample of sheep or goats. Purified PCR products of T. axei isolates were successfully sequenced and revealed 3 haplotypes; 2 from sheep and 1 from goats, and the isolates are related genetically to T. axei isolates from camels in Egypt. Phylogenetic analysis of the Genbank-retrieved ITS2-amplified T. axei isolates worldwide suggested the existence of genetic variants. Earlier reports on the identified Trichostrongylus spp. in different animals from Egypt as well as African and Arabian countries are tabulated.

Prevalence of Eimeria species in sheep (Ovis aries) from Dakahlia governorate, Egypt

Feces from 184 sheep from Dakahlia governorate, Egypt were tested for Eimeria species oocysts by using the standard floatation technique; oocysts were detected in 126 (68.4%). The prevalence was significantly higher in young sheep than adults. Eleven Eimeria species were identified: Eimeria ahsata, Eimeria bakuensis, Eimeria crandallis, Eimeria faurei, Eimeria granulosa, Eimeria intricata, Eimeria marsica, Eimeria ovinoidalis, Eimeria pallida, Eimeria parva and Eimeria webybridgensis. Oocysts of the most pathogenic ovine species, E. ovinoidalis, were detected in 27 (14.6%) sheep. This is the first report of E. webybridgensis in sheep from Egypt, possibly due to close similarity of their oocysts to those of E. crandallis which stated in the earlier reports. Worldwide reports on epidemiology of Eimeria spp. infections in sheep are tabulated.

Effect of adding a capsule with activated charcoal to abdominal ultrasound preparation on image quality

Background

Patient preparation for routine abdominal ultrasound, such as fasting for 8 hours and having a light meal the night before the examination, is a common practice employed to avoid digestive motility and gases, which are considered the main causes of artifacts and image quality degradation.

Importance of this study

Patient preparation before abdominal ultrasound plays a major role to ensure better visualization of internal organs and pathologies by minimizing artifacts, but because abdominal gases are still present in many patients and in large amounts, causing artifacts, it is important to search for new, safe, efficient, reliable and cost-effective methods to improve patient preparation by eliminating excessive abdominal gases.

Material and method

This was a prospective study involving a randomly selected sample of 52 adult patients, both men and women, of different age groups. The participants met the inclusion criteria and had no history of previous or current abdominal surgery. Pediatric patients, pregnant women, patients with a history of abdominal surgery, bedridden patients, and patients with bowel obstruction were excluded. Routine abdominal ultrasound was performed after usual patient preparation involving fasting for 8 hours. Subsequently, the same patients were asked to come again after 48 hours for re-scanning and were instructed to follow the same routine preparation and to take one capsule of activated charcoal 8 hours before re-scanning. The results of both scans were compared by focusing on the pancreas as the reference.

Result

Significant improvement by 57.2% was noticed in overweight, obese and extremely obese patients. The improvement noted in underweight patients and in patients with normal weight was 39.05%. The improvement in males reached 66.9% while in females: 49.9%. The overall improvement in pancreas visualization was 63%.

Conclusion

Our preliminary study concluded that activated charcoal can be used to reduce gastrointestinal gases efficiently, providing an inexpensive, safe and easy-to-use method to improve visualization in routine abdominal ultrasound scans in adults.

First Evidence of Teladorsagia circumcincta Infection in Sheep from Egypt

Trichostrongylid nematodes are a common cause of gastroenteritis in sheep. Despite its worldwide distribution, Teladorsagia circumcincta has not been included in reports listing the various trichostrongyles infecting sheep from Egypt. Herein, we describe the presence of 2 T. circumcincta haplotypes infecting small ruminants from Egypt. For this study, fresh fecal samples were collected from 340 sheep and 115 goats reared at 5 districts in Dakahlia governorate and its surroundings, Egypt. Trichostrongyle eggs were harvested from the samples, and then subjected to DNA isolation and analysis. Polymerase chain reaction (PCR) amplification was carried out for the second internal transcribed spacer of ribosomal DNA (ITS2 rDNA). Purified PCR products of T. circumcincta were sequenced, and the revealed sequences were subjected to the nucleotide and phylogenetic analysis. A relatively high prevalence of trichostrongyles eggs was identified in sheep (33.2%) and a lower prevalence was found in goats (14.7%). Molecular analysis revealed, for the first time, 2 sheep herds from Egypt that were infected with T. circumcincta. Both infected herds were raised by the Bedouins in rural areas of El Mahalla El Kubra city. No T. circumcincta infections were found in any of the goats. Nucleotide sequence analysis revealed 2 haplotypes (Te1 and Te2) from 7 successfully sequenced samples (5 from the first and 2 from the second herd). Te1 was the major haplotype in both herds, and Te2 was retrieved from a single sample. Phylogenetic analysis displayed that the Te1 haplotype clustered with one from Cyprus, which might have been introduced to Egypt via goats imported from Cyprus due to a program to improve meat and milk production in Egypt. The present results could be beneficial in understanding the epidemiology of T. circumcincta and other trichostrongyles in Egypt, and have implementations in the effective control strategies used in this region.

Egg autofluorescence and options for detecting peanut agglutinin binding for the identification of Haemonchus contortus eggs in fecal samples

Quantifying eggs from Haemonchus and other trichostrongyle genera in sheep and goat fecal samples is important for evaluating control and treatment strategies for this family of nematodes with divergent pathologies, capabilities for anthelmintic resistance and environmental susceptibilities. Unfortunately, egg morphology among most of the genera do not differ enough to support the accurate identification of these genera with standard microscopic techniques. Several studies have identified specific lectins which bind selectively to sugars located on the egg surfaces for individual genera among the trichostrongyles. To detect lectins binding to these eggs, they must be directly or indirectly bound to fluorophores, and observed with an epi-fluorescence microscope. The binding of multiple lectins to isolated eggs from a fecal sample can be simultaneously detected if fluorophores are used whose excitation and emission spectra do not overlap, and this would enable the development of a fluorescence-based diagnostic test that identifies multiple trichostrongyle genera within each sample. The present study compared the usefulness of different, commercially available detection systems for use in detecting lectin binding to trichostrongyle eggs. Comparisons were made using the detection of PNA binding to H. contortus eggs with the goal of finding three systems with color spectra that do not overlap. These evaluations included both fluorophores directly conjugated to PNA in a one-step incubation protocol and a two-step incubation protocol involving biotinylated PNA and streptavidin conjugated to different fluorophores. Autofluorescence can affect the efficiency of any fluorescence-based detection system, and significant autofluorescence was observed among the unstained H. contortus eggs with the DAPI-type fluorescence filter, but it was significantly lower with the FITC-type filter and was virtually absent with the rhodamine-type filter. This study demonstrated that all the PNA detection methods tested with H. contortus eggs generated fluorescence intensities (FIs) that were significantly above the autofluorescence generated by the eggs among the three different fluorescence filters. Fluorescence intensities from PNA directly conjugated to either the FITC or rhodamine fluorophores were not different, but the lower autofluoresence in the rhodamine-type filter will enable this fluorophore to be detected more efficiently. Use of biotinylated PNA combined with streptavidin-conjugated to synthetic fluorophores (Alexa Fluor 405, 488 and 546) significantly increased FIs over that of the directly conjugated PNA, but there were no significant differences in FIs among these three biotin-avidin conjugation fluorophores. This biotin-avidin system required two incubation steps. Doubling the concentration of PNA also provided increased FI, at least for the biotin-avidin system. Adding an additional amplification step to the biotin-avidin system involving biotinylated anti-streptavidin followed by the streptavidin-Alexa Fluor complex also provided additional fluorescence.

Genetic variability within isolates of Sarcocystis species infecting sheep from Egypt

In order to explain the exact role of sarcocystosis, principally Sarcocystis tenella, in losses of the Egyptian sheep industry, a precise confirmation about the existence of different Sarcocystis species infecting that economically important animal is needed. Therefore, this work aimed to molecularly identify, as well as illustrate the genetic variability within isolates of Sarcocystis spp. infecting sheep from Egypt. Tissue specimens were collected from sheep slaughtered at 3 Egyptian provinces; Cairo, Dakahlia and Damietta. DNA was isolated from the harvested bradyzoites after peptic digestion for the positive sarcocysts infected specimens, and then PCR amplification using the 18S rRNA gene was carried out. PCR products were subjected to gel electrophoresis. DNA from 600 bp gel bands was purified and sequenced. The revealed sequences were compared to their similarities on Genbank, and analyzed both clusterally and phylogenetically. Two Sarcocystis spp. were identified, the macroscopic cyst forming S. gigantea and the microscopic cyst forming S. tenella. Nine S. tenella sequences were analyzed, resulting in 3 polymorphic sites as well as 3 different haplotypes. Clustering of the nine obtained S. tenella sequences in addition to another 23 S. tenella sequences on Genbank revealed low nucleotide (0.001780) diversity as well as negative value of the Taijma neutral index which are indicators for population expansion. Alignment and Phylogeny results illustrated very close relationship between S. gigantea and S. moulei, a goat specific species which rarely reported in sheep, and in turn proposed the cross transmission of the later species between sheep and goats.

Molecular and epidemiological updates on cystic echinococcosis infecting water buffaloes from Egypt

Aim:

Cystic echinococcosis (CE) represents a serious parasitic disease at both animal and public health levels. The majority of reports negated the CE infection in buffaloes from Egypt; however, one study illustrated their infection with G6 genotype (camel strain). The present work contributed to update the epidemiological and molecular knowledge about CE infecting this economically important animal for better understanding of its role in maintaining the Echinococcus life cycle.

Materials and Methods:

A total of 120 slaughtered water buffaloes at Mansoura abattoir, Dakahlia province, Egypt, were inspected for the existence of hydatid cysts. Cysts location and fertility were examined. Five out of 27 revealed cysts were tested molecularly using both cytochrome C oxidase subunit 1 and nicotinamide adenine dinucleotide hydrogen subunit 1 (nadh1) genes.

Results:

Low prevalence (4.2%) as well as considerably low fertility rate (14.8%) of buffaloes CE was noted. G1 genotype (common sheep strain) was revealed from the five examined cysts. At the level of nadh1 partial sequences, a globally singleton G1 haplotype was reported.

Conclusion:

This the first report about the G1 infection in buffaloes from Egypt. This study proposed the minimized role of this animal in echinococcosis transmission. These findings could provide preliminary data for the local control of this disease.

Occult hepatitis B virus coinfection in HIV-positive African migrants to the UK: a point prevalence study

Objectives

Occult (surface antigen-negative/DNA-positive) hepatitis B virus (HBV) infection is common in areas of the world where HBV is endemic. The main objectives of this study were to determine the prevalence of occult HBV infection in HIV-infected African migrants to the UK and to determine factors associated with occult coinfection.

Methods

This anonymized point-prevalence study identified Africans attending three HIV clinics, focussing on patients naïve to antiretroviral therapy (ART). Stored blood samples were tested for HBV DNA. Prevalence was calculated in the entire cohort, as well as in subpopulations. Risk factors for occult HBV coinfection were identified using logistic regression analysis.

Results

Among 335 HIV-positive African migrants, the prevalence of occult HBV coinfection was 4.5% [95% confidence interval (CI) 2.8–7.4%] overall, and 6.5% (95% CI 3.9–10.6%) and 0.8% (95% CI 0.2–4.6%) in ART-naïve and ART-experienced patients, respectively. Among ART-naïve anti-HBV core (anti-HBc)-positive patients, the prevalence was 16.4% (95% CI 8.3–25.6%). The strongest predictor of occult coinfection was anti-HBc positivity [odds ratio (OR) 7.4; 95% CI 2.0–27.6]. Median HBV DNA and ALT levels were 54 IU/mL [interquartile range (IQR) 33–513 IU/mL] and 22 U/L (IQR 13–27 U/L), respectively.

Conclusions

Occult HBV coinfection remains under-diagnosed in African HIV-infected patients in the UK. Given the range of HBV DNA levels observed, further studies are warranted to determine its clinical significance and to guide screening strategies and ART selection in these patients.

Some determinants of factors associated with HIV/AIDS risk behaviours among University of Dodoma students in Tanzania

The paper examines whether variables of HIV/AIDS related knowledge, attitude and beliefs of Dodoma University students (UDOM) can predict practices which risk HIV infection. A pre-designed questionnaire was administered in a sample of 547 (539 students and 8 staff members). Since variables involved were many and in many cases highly correlated and unobservable, data were analyzed using factor analysis. Multiple regression analysis were used to analyze factor scores obtained from factor analysis. Based on responses of students to practice questions, two factors emerged and were labeled as sex with high risk persons and common risk sexual behavior. The common predictors in the Multiple Linear Regression (MLR) for sex with high risk persons score (R2 = 5.1%, p < 0.001, F = 4.873) and sex under the influence of alcohol (p < 0.001) respectively both had significant contribution from gender, knowledge on transmission through sexual contact, beliefs about HIV/AIDS and attitudes toward VCT testing. The MLR for common risk sexual behavior score (R2 = 5.4%, p < 0.001, F = 5.147) and sex without condom (p < 0.001) respectively both had significant contributions from gender and attitudes toward condom use. Knowledge on transmission through sexual contact, beliefs about HIV/AIDS and attitudes toward VCT testing and condom use appeared to be common determinants of HIV/AIDS risk behaviors among students.

[Theoretical model of a cost-effectiveness analysis of combined enalapril-nitrendipine therapy for treating hypertension]

OBJECTIVE

Cost-effectiveness analysis of combined enalapril-nitrendipine therapy (E/N), as second-line therapy for light or moderate hypertension.

DESIGN

Theoretical model of cost-effectiveness, based on the norms of hypertension treatment in primary care, the considered view of a panel of experts and the direct costs of health resources and purchase of medication.

SETTING

Spanish National Health system.

PARTICIPANTS

Simulation of 1000 patients with hypertension, with a time horizon of one year.

INTERVENTIONS

After a prior failure of the first-line treatment with either enalapril or nitrendipine, an evaluation was made of the possibilities of increasing dosage of the first-line treatment, changing the drug or administering the E/N combination.

MAIN MEASUREMENT

The likelihoods, in the primary care context, of controlling diastolic pressure, of abandonment and of using the two strategies or not were measured, as were the use of health resources in each situation, and costs of resource use and of medication.

RESULTS

The cost-effectiveness quotient of the combined E/N treatment was consistently more efficient than the increase in dose or change to another drug. This was so, whether the treatment was started with enalapril (301.06 euros vs 337.97 euros and 588.42 euros) or with nitrendipine (331.5 euros vs 469.88 euros and 579.76 euros).

CONCLUSIONS

Combined therapy (E/N) is, on the basis of the assumptions made in the model, an efficient therapy option. Therefore, it can be recommended for prescription.

Saccharomonospora halophila sp. nov., a novel halophilic actinomycete isolated from marsh soil in Kuwait

An actinomycete, strain 8T, was isolated from marsh soil in Kuwait. The strain was aerobic, gram-positive, halophilic and produced light blue to greyish aerial mycelium. The warty spores were sessile, occurring singly or in pairs on aerial mycelium. The mycelium was stable and did not fragment during ageing. Chemotaxonomic markers of the isolate were consistent with its classification as Saccharomonospora. The strain possessed meso-diaminopimelic acid as the diagnostic amino acid in the peptidoglycan. The diagnostic sugars were arabinose and galactose; polar lipids were phosphatidyl inositol, phosphatidyl ethanolamine, hydroxy-phosphatidyl ethanolamine, lyso-phosphatidyl ethanolamine and diphosphatidyl glycerol; the principal menaquinone was MK-9(H4); and the iso/anteiso-branched fatty acid pattern was combined with 10-methyl-branched and 2-hydroxy-branched fatty acids. Saccharomonospora cyanea DSM 44106T was the closest phylogenetic neighbour of strain 8T, showing 96.8% 16S rDNA sequence similarity. These data, together with distinct physiological traits, led to the conclusion that the novel isolate represents a new species within the genus Saccharomonospora for which the name Saccharomonospora halophila sp. nov. is proposed. The type strain is strain 8T (= DSM 44411T =NRRL B-24125T).

Nocardiopsis halotolerans sp. nov., isolated from salt marsh soil in Kuwait

A polyphasic taxonomic study of a halotolerant micro-organism, isolated from Kuwait salt marsh soil, revealed that this strain represents a novel Nocardiopsis species. The strain produced substrate and aerial mycelium, grew at 28-35 degrees C in salt concentrations of 0-15% and was slightly keratinolytic. Results of the 165 rDNA sequence comparison revealed that strain F100T clustered with strains of the genus Nocardiopsis. This is consistent with other data such as: (i) growth characteristics, i.e. the formation of a white to yellow aerial mycelium and the typical zig-zag form of hyphae, which fragment when ageing; (ii) the presence of DL-diaminopimelic acid and glucose plus ribose in whole-cell hydrolysates; (iii) the presence of phosphatidyl choline, phosphatidyl inositol, phosphatidyl glycerol, phosphatidyl methylethanolamine and diphosphatidyl glycerol in polar lipid extracts; (iv) the presence of menaquinones MK-10(H(0-6)) and MK-11(H(0-6)) in the non-polar fraction; (v) the presence of iso/anteiso-branched plus 10-methyl-branched fatty acids, showing the diagnostic combination for Nocardiopsis spp. of 14-methyl-hexadecanoic acid (18%), oleic acid (9%) and tuberculostearic acid (2%); and (v) the absence of mycolic acids. Analysis of 16S rDNA revealed that strain F100T represents a distinct taxon within Nocardiopsis. Based upon phenotypic differences to other members of the genus, a novel species, Nocardiopsis halotolerans sp. nov., is proposed. The type strain of the species is F100T (= DSM 44410T = NRRL B-24124T).

[Health care resources utilization in HIV-infected patients: creation of a data base and cost results]

OBJECTIVES

To make and validate a data base that allows to collect information about clinical characteristics and use of health care services by HIV-infected patients. An additional purpose is to obtain some data about costs of health care services utilization.

METHODS

We have designed an informatic data base that includes: demographic data, clinical data and health care services utilization during the follow up. One hundred and nine patients were selected from 5 different hospitals in Spain and they were followed for 6 months (from January to June 1997). Analytic accounting of one hospital and official tariffs were used to calculate costs of the health care services.

RESULTS

The informatic data base designed is useful and appropriate to collect the information of these patients. The annual average cost is 2.5 millions dollars, ranging from 1 million dollars for asymptomatic patients to 3.8 millions for AIDS patients. The comparison of our results with previous studies shows an increased cost of asymptomatic patients.

CONCLUSIONS

These results give a preliminary information about health care services utilization by HIV-infected patients and confirm the possibility of using the designed instrument in the future. Since HIV-infection presents an uncertain evolution and a variable prognosis, to implant a tracking system is a necessary requirement in order to obtain a fast and accurate information system about the evolution of clinical variables and their economic repercussions.