Waleed E. Elawamy

Ventilator-associated pneumonia (VAP) is linked to high mortality rates, especially in developing countries. This cross-sectional survey study was conducted across three central hospitals in the Hail region of Saudi Arabia, King Salman Specialist Hospital, Hail General Hospital, and King Khalid Hospital, to assess the knowledge and adherence of intensive care unit (ICU) healthcare practitioners to the ventilator bundle (VB) for VAP prevention. It also looked at the practitioners’ perceived barriers to effective VB deployment. The study (n = 86) revealed significant disparities in VAP prevention knowledge across educational levels regarding the recommended degree of head-of-bed (HOB) elevation (p < 0.001), the use of endotracheal tubes with extra lumens for subglottic drainage (p < 0.001), and the protective effects of 0.12% chlorhexidine gluconate antiseptic oral rinse (p = 0.019). Professional experience significantly influenced knowledge of non-standard VB components (p < 0.001), the recommended frequency of awakening and spontaneous breathing trials (SBTs) (p < 0.001), and knowledge of extra-lumen tubes (p = 0.038) and kinetic beds vs. standard beds (p = 0.005). Significant differences were found between professional categories regarding knowledge of hand hygiene performance (p = 0.032), the correct degree of HOB elevation (p = 0.007), and patient positioning (semi-recumbent vs. supine) (p = 0.023). Years of experience significantly impacted reported compliance with institutional VB (p = 0.013), adherence to oral care protocols (p = 0.035), and the assessment of sedation depth (p = 0.002). While basic measures like HOB elevation practice and DVT prophylaxis showed universal reported compliance (100%), significant performance gaps were identified in more complex tasks, such as interrupting continuous sedative infusions and performing SBTs as recommended (p < 0.001), particularly among novice practitioners. The primary implementation barrier preventing full compliance with the VB was identified as educational deficit, which was prioritized as the most important area for quality improvement, highlighting the need for targeted training for newly hired ICU staff.

Background. Micronutrient deficiency is a great problem that is augmented by infection and poor nutrition. Iron, zinc, and selenium are trace elements needed for human growth. Objective. To investigate the impact of parasitic infection on nutritional status and serum iron, zinc, and selenium in children attending Pediatrics Outpatient Clinic of Zagazig University Hospitals. Subjects and Methods. A case-control study included 140 parasitic infected children and one hundred age- and sex-matched controls. Anthropometric measures were evaluated using specific Egyptian growth charts. Parasites were detected in stool specimens using standard microscopic methods. Atomic absorption spectrophotometer was used for the detection of serum iron, zinc, and selenium. To examine the statistical relationship between intestinal parasitic infection and the relevant variables (gender, residence, socioeconomic status, and age group), the nonparametric chi-square () test was used. Data were analyzed statistically using SPSS version 25. Results. Parasitic infected children showed a statistically significant low weight for age, height for age, and BMI. Serum iron, zinc, and selenium were significantly lower in parasitic infected children than controls. Serum iron, zinc, and selenium have significant positive correlations with weight, height, and BMI, respectively. Conclusion. Studied serum micronutrients especially zinc and iron and anthropometric indices were significantly lower in parasitically infected children.

Introduction: The Ministry of Health in Saudi Arabia provides comprehensive antenatal care for all pregnant women with all required investigations. However, it does not include urine culture for diagnosis of asymptomatic bacteriuria (ASB). This is the first study to evaluate the prevalence of ASB among pregnant females, identify the causative organisms and determine their antibiotic susceptibility patterns in the Maternity and Children’s Hospital, Arar, Saudi Arabia. Methodology: This cross-sectional study included 400 pregnant women attending an antenatal clinic. Two midstream urine samples were aseptically collected and screened using standard microbiological techniques including microscopic examination, dipstick testing, and urine culture. In order to interpret the urine culture results, ≥ 105 CFUs/mL was considered significant bacteriuria. Identification of the isolates and their antibiotic sensitivity testing was performed using the Vitek 2 system (BioMérieux, Marcy l'Etoile, France) with the available test kits. Results: The prevalence of ASB was 8.25% (35/400). Significant positive correlations (p ˂ 0.05) were detected between positive urine culture results and random blood sugar, leucocytes, nitrites, pus cells, urine red blood cells, epithelial cells, and mucus. Escherichia coli was the most common causative organism (45.7%), followed by Staphylococcus aureus (22.9%). Klebsiella pneumoniae represented 11.4% of the isolates. Most of the isolated Gram-positive organisms were sensitive to many of the tested antibiotics; most of the detected Gram-negative isolates were resistant. Conclusions: ASB caused by antibiotic resistant organisms is alarming. Screening for ASB during pregnancy using urine culture and sensitivity testing is of vital importance to improve the maternal and neonatal outcome.

Background: Concomitant T. gondii and H. pylori infections are two widespread diseases transmitted by fecal-oral route. Several studies documented association of both infections in gastritis and peptic ulcer diseases. Objective: The aim of this work is to evaluate the relation between recurrent gastritis or gastric ulcers and coinfection with H. pylori and T. gondii. Patients and Methods: Investigations included upper gastrointestinal tract (GIT) endoscopic biopsy, detailed personal questionnaire, serum detection of anti-cag A and anti-vac A for H. pylori, anti-Toxoplasma IgM and IgG antibodies. Selected cases were from patients attending the Gastroenterology and Hepatology Department of Kafrelsheikh University Hospital. In total, 80 participants were distributed as 32 naïve cases, 28 recurrent and 20 with no gastric diseases as control. For diagnosis of H. pylori, sandwich ELISA immunoassay (EIA) test was performed to detect H. pylori surface coproantigen in fresh stools taken after endoscopy. In patients’ serum samples, IgG for H. pylori cag-A and vac-A antigens, IgM and IgG for T. gondii were detected by ELISA. Results: Recurrence of H. pylori infection increased in age groups 21-30 and 31-40 years, mainly in males and in those eating junk foods. Severe gastric ulcers appeared in combined H. pylori and T. gondii infections. Recurrent cases showed 71.4% positive H. pylori anti-cag A, 57.1% H. pylori anti-vac A, 35.7% both H. pylori antigens, 57.1% anti-Toxoplasma IgM, and 71.4% anti-Toxoplasma IgG, 35.7% concomitant bacterial and parasitic infection. High IgM positivity rate was recorded in recurrent cases while IgG was recorded in naïve cases. Conclusion: Toxoplasmosis when combined with H. pylori participates in recurrence of the latter, causing higher severity of gastritis and gastric ulcer. Eating junk foods and being middle aged are contributing risk factors.

Covalent loading or directional binding of biomolecules on gold nanoparticles (AuNPs) could lead to better results than simple direct adsorption for an enhanced ELISA application. The use of Mini-Parasep solvent-free (SF) without ether or ethyl acetate for the clean and efficient concentration of protozoa cysts, it is a single-use device for in vitro diagnostic use only. In this work, we used Mini-Parasep SF for the detection of giardia cysts in comparison to direct smear and Merthiolate-Iodine Formaldehyde Concentration (MIFC) technique in addition to its use in antigen detection by AuNPs biomolecule loading using rabbit polyclonal antibodies (pAb) against purified Giardia antigen (PGA). As a result, Mini-Parasep SF was the most effective method for Giardia cyst detection and regarding optimization of Mini-Parasep antigen detection, our data showed increased sensitivity and specificity of nano-sandwich ELISA to 92% and 94% respectively and increased positive predictive value (PPV) and negative predictive value (NPV) to 88.64% and 95.91% respectively. In conclusion, this research provides that Mini-Parasep SF concentrator enhanced Giardia cyst detection and improved antigen preparation for AuNPs sandwich ELISA in giardiasis diagnosis. The advantages of this method are the short assay time and the raised accuracy of antigen detection providing concentrated samples without the risk of solvent use and being a disposable Mini-Parasep it helps in giardia antigen purification as well as raising the sensitivity and specificity of ELISA through binding AuNPs.

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Background: Human cystic echinococcosis is a zoonosis occurring due to dogs handling and exposure to Echinococcus granulosus ova in their stools being an accidental intermediate host. Serology remains the only sure and important tool to diagnose this disease. Our objectives in this research are to improve the serodiagnostic abilities of sandwich ELISA through its binding to gold nanoparticle and proving the role of minute nanoparticles in serodiagnosis. Methods: gold nanoparticles (AuNPs) were employed for the capture of the antigens of protoscolices (pAg) in the patient’s serum by sandwich ELISA. Cross-reactivity for antigens from Hymenolepis nana , Entrobius vermicularis , and Fasciola gigantica was ruled out by using anti-protoscolices polyclonal antibodies (ppAb). (pAg) of sonicated protoscolices which were removed from camel lung cysts, was purified by diethyl aminoethyl Sephadex (DEAE-Sephadex) and injected to a New zealand white rabbit giving ppAb which then conjugated to horseradish peroxidase (HRP) and loaded on AuNPs being used as a diagnostic indicator for circulating pAg by both sandwich ELISA and nanogold sandwich ELISA techniques. Results: Nanogold sandwich ELISA was able to give positive results with 96.3% of hydatid patients and 5% of non-hydatid patients while sandwich ELISA showed 81.4% and 20% positive cases of the same groups respectively. The sensitivity and specificity of nanogold sandwich ELISA were 96.3% & 95% against 81.5% & 80% for those of sandwich ELISA respectively. Conclusion: The conjugation of AuNPs to anti- Echinococcus IgG antibodies seems to be beneficial to maximize the sensitivity of sandwich ELISA, reduce the overall cost of the assay as less antibody was needed, solve harsh buffering conditions and achieve greater stability which provides a reliable quantitation of analytes.

This research evaluates the value of loading Nigella sativa on chitosan nanoparticles (ChNPs) in the treatment of Schistosoma mansoni infection compared to praziquantel. Chitosan has efficient oral administrative capability to penetrate mucosal surface being mucoadhesive and non-toxic, as well as combination with NPs add characters of controlled release and safe serum levels. The study was done on 40 S. mansoni infected male mice which were divided into 4 groups: positive control group (infected, non treated), group treated with N. sativa only (NS), group treated with N. sativa loaded chitosan NPs (NC) and group treated with combined praziquantel and N. sativa loaded chitosan nanoparticles (NCP). Results showed decreased worm burden in NC and NCP groups concerning the control and NS groups while significant decrease occurred in oogram pattern and tissue egg loads reached reduction percentages more than 90% in NC and NCP groups. On the level of granuloma diameter reduction, it was 46.3% in NC and 41.3% in NCP group while granuloma number was reduced by 50.9% in NC and reduced by 32% in NCP group revealing the apparent role of ChNPs in improvement of bilharzial hepatic changes. Thus, ChNPs improved the effects of N. sativa in therapy of murine schistosomal infection by enhancing the effects of praziquantel and reducing the resistance to it. This can be considered as a new strategy using ChNPs as anti-schistosomal drug carrier in mice models. Key words: Nigella sativa, chitosan nanoparticles, Schistosoma mansoni, praziquantel

The mite Blomia tropicalis has significant prevalence worldwide. Blo t 5 is a major B. tropicalis allergen that has been associated with sensitization and allergic symptoms in many asthmatic patients. Besides house dust, contaminated foodstuffs are an important source of exposure to B. tropicalis allergens. In this study, a double sandwich enzyme-linked immunosorbent assay (ELISA) using mAb 4D4 and biotinylated mAb 4G9 was done to detect Blo t 5 allergen in different types of raw and processed foods, including wheat, corn, rice, bean, wheat and corn flour, cake, and rusk, which were collected from retail stores in the Nile Delta of Egypt. Out of 88 samples, 38 (43.2%) were positive for Blo t 5 allergen with no significant statistical difference in positivity according to food type. In positive samples, the Blo t 5 concentration ranged from 10 ng/g to 790 ng/g. This study showed that Blo t 5 should be considered as an important allergen that presents a risk to the Egyptian population and should become a routine allergen in the skin prick test to improve the management of allergic disease.