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1.  Brief communication genotyping of Burkholderia pseudomallei revealed high genetic variability among isolates from a single population group 
Burkholderia pseudomallei is a soil dwelling Gram-negative bacteria predominates in Southeast Asia zone and the tropical part of Australia. Genetic diversity has been explored among various populations and environments worldwide. To date, little data is available on MLST profiling of clinical B. pseudomallei isolates in peninsular Malaysia. In this brief report, thirteen culture positive B. pseudomallei cases collected from a single population of Terengganu state in the Western Peninsular Malaysia and were confirmed by In-house TTS1-PCR. Isolates were subjected for multi-locus sequence typing (MLST) to explore their genotypic diversity and to investigate for possible clonal clustering of a certain sequence type. Patient’s clinical information was examined to investigate for clinical correlation among the different genotypes. In spite of small sample set, MLST results indicated predictive results; considerable genotypic diversity, predominance and novelty among B. pseudomallei collected over a single geographically-located population in Malaysia. Massive genotypic heterogeneity was observed; 8 different sequence types with predominance of sequence type 54 and discovery of two novel sequence types. However, no clear pathogenomic or organ tropism clonal relationships were predicted.
PMCID: PMC4572092  PMID: 26417404
Burkholderia pseudomallei; melioidosis; multi-locus sequence typing; Malaysia
2.  Detection of Strongyloides stercoralis infection among cancer patients in a major hospital in Kelantan, Malaysia 
Singapore Medical Journal  2014;55(7):367-371.
Strongyloidiasis is one of the most commonly neglected but clinically important parasitic infections worldwide, especially among immunocompromised patients. Evidence of infection among immunocompromised patients in Malaysia is, however, lacking. In this study, microscopy, real-time polymerase chain reaction (PCR) and enzyme-linked immunosorbent assays (ELISAs) were used to detect Strongyloides stercoralis (S. stercoralis) infection among cancer patients in a Malaysian hospital.
A total of 192 stool and serum samples were collected from cancer patients who were receiving chemotherapy with or without steroid treatment at a hospital in northeastern Malaysia. Stool samples were examined for S. stercoralis using parasitological methods and real-time PCR. Serology by ELISA was performed to detect parasite-specific immunoglobulin G (IgG), IgG4 and immunoglobulin E (IgE) antibodies. For comparison, IgG4- and IgG-ELISAs were also performed on the sera of 150 healthy individuals from the same area.
Of the 192 samples examined, 1 (0.5%) sample was positive for S. stercoralis by microscopy, 3 (1.6%) by real-time PCR, 8 (4.2%) by IgG-ELISA, 6 (3.1%) by IgG4-ELISA, and none was positive by IgE-ELISA. In comparison, healthy blood donors had significantly lower prevalence of parasite-specific IgG (2.67%, p < 0.05) and IgG4 (2.67%, p < 0.05) responses.
This study showed that laboratory testing may be considered as a diagnostic investigation for S. stercoralis among immunocompromised cancer patients.
PMCID: PMC4291962  PMID: 25091885
cancer patients; ELISAs; microscopy; real-time PCR; Strongyloides stercoralis
3.  The epidemiology and clinical spectrum of melioidosis in a teaching hospital in a North-Eastern state of Malaysia: a fifteen-year review 
BMC Infectious Diseases  2016;16:333.
Over the last two decades, many epidemiological studies were performed to describe risks and clinical presentations of melioidosis in endemic countries.
We performed a retrospective analysis of 158 confirmed cases of melioidosis collected from medical records from 2001 to 2015 in Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia, in order to update the current status of melioidosis clinical epidemiology in this putatively high risk region of the country.
Principal presentations in patients were lung infection in 65 (41.1 %), skin infection in 44 (27.8 %), septic arthritis/osteomyelitis in 20 (12.7 %) and liver infection in 19 (12.0 %). Bacteremic melioidosis was seen in most of patients (n = 121, 76.6 %). Focal melioidosis was seen in 124 (78.5 %) of patients and multi-focal melioidosis was reported in 45 (28.5 %) cases. Melioidosis with no evident focus was in 34 (21.5 %) patients. Fifty-four (34.2 %) patients developed septic shock. Internal organ abscesses and secondary foci in lungs and/or soft tissue were common. A total of 67 (41 %) cases presented during the monsoonal wet season. Death due to melioidosis was reported in 52 (32.9 %) patients, while relapses were occurred in 11 (7.0 %). Twelve fatal melioidosis cases seen in this study were directly attributed to the absence of prompt acute-phase treatment. Predisposing risk factors were reported in most of patients (n = 133, 84.2 %) and included diabetes (74.7 %), immune disturbances (9.5 %), cancer (4.4 %) and chronic kidney disease (11.4 %). On multivariate analysis, the only independent predictors of mortality were the presence of at least one co-morbid factor (OR 3.0; 95 % CI 1.1–8.4), the happening of septic shock (OR 16.5; 95 % CI 6.1–44.9) and age > 40 years (OR 6.47; 95 % CI 1.7–23.8).
Melioidosis should be recognized as an opportunistic nonfatal infection for healthy person. Prompt early diagnosis and appropriate antibiotics administration and critical care help in improved management and minimizing risks for death.
PMCID: PMC4947242  PMID: 27423906
Melioidosis; B. pseudomallei; Pneumonia; Bacteremia; Malaysia; Dissemination
Nagoya Journal of Medical Science  2015;77(1-2):59-68.
To describe the clinical characteristics and the risk factors associated with mortality in patients with meningitis. This is a retrospective review of patients diagnosed to have meningitis with positive culture of the cerebrospinal fluid (CSF) specimen. All cases aged 19 > years who were admitted to Hospital USM between January 2004 and December 2011 were included in the study. The CSF results database were obtained from the Department of Medical Microbiology and Parasitology, Hospital USM, Kelantan. A checklist was used to record the clinical characteristics. A total of 125 cases met the inclusion criteria. The age of patients ranged between newborn and 19 years old (Mean±SD, 74.5±80.6 months). The majority of them were males (65.6%). Fever was the most common presentation (73.6%) followed by poor oral intake (48.0%), seizure (36.0%) and headache (24.8%). The mortality rate was 31.2%. Coagulase negative staphylococcus was the most frequent pathogens isolated (21.6%), followed by Acinetobacter spp. (17.6%), Staphylococcus aureus (13.6%), Streptococcus spp. (11.2%) and Klebsiella pneumoniae (6.4%). There were significant association of in-hospital death with age (p=0.020) and conscious level (p=0.001). Infectious meningitis is a big health concern, especially among children. We found that coagulase negative staphylococcus, Acinetobacter species, S. aureus, Streptococcus spp and K. pneumoniae were prevalent in our hospital. These microorganisms were hospital associated pathogens. The 31% mortality linked to hospital acquired meningitis specifies the need for focused physician attention especially among younger aged patients.
PMCID: PMC4361508  PMID: 25797971
Bacterial meningitis; children; CSF; Mortality
5.  Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two 
Lomakina, Olga | Alekseeva, Ekaterina | Valieva, Sania | Bzarova, Tatiana | Nikishina, Irina | Zholobova, Elena | Rodionovskaya, Svetlana | Kaleda, Maria | Nakagishi, Yasuo | Shimizu, Masaki | Mizuta, Mao | Yachie, Akihiro | Sugita, Yuko | Okamoto, Nami | Shabana, Kousuke | Murata, Takuji | Tamai, Hiroshi | Smith, Eve M. | Yin, Peng | Jorgensen, Andrea L. | Beresford, Michael W. | Smith, Eve M. | Eleuteri, Antonio | Goilav, Beatrice | Lewandowski, Laura | Phuti, Angel | Wahezi, Dawn | Rubinstein, Tamar | Jones, Caroline | Newland, Paul | Marks, Stephen | Corkhill, Rachel | Ekdawy, Diana | Pilkington, Clarissa | Tullus, Kjell | Putterman, Chaim | Scott, Chris | Fisher, Antony C. | Beresford, Michael W. | Smith, Eve M. | Lewandowski, Laura | Phuti, Angel | Jorgensen, Andrea | Scott, Chris | Beresford, Michael W. | Batu, Ezgi Deniz | Kosukcu, Can | Taskiran, Ekim | Akman, Sema | Ozturk, Kubra | Sozeri, Betul | Unsal, Erbil | Ekinci, Zelal | Bilginer, Yelda | Alikasifoglu, Mehmet | Ozen, Seza | Lythgoe, Hanna | Beresford, Michael W. | Brunner, Hermine I. | Gulati, Gaurav | Jones, Jordan T. | Altaye, Mekibib | Eaton, Jamie | Difrancesco, Mark | Yeo, Joo Guan | Leong, Jingyao | Bathi, Loshinidevi D/O Thana | Arkachaisri, Thaschawee | Albani, Salvatore | Abdelrahman, Nagla | Beresford, Michael W | Leone, Valentina | Groot, Noortje | Shaikhani, D. | Bultink, I. E. M. | Bijl, M. | Dolhain, R. J. E. M. | Teng, Y. K. O. | Zirkzee, E. | de Leeuw, K. | Fritsch-Stork, R. | Kamphuis, S. S. M. | Wright, Rachael D. | Smith, Eve M. | Beresford, Michael W. | Abdawani, Reem | Al Shaqshi, Laila | Al Zakwani, Ibrahim | Gormezano, Natali W. | Kern, David | Pereira, Oriany L. | Esteves, Gladys C. C. | Sallum, Adriana M. | Aikawa, Nadia E. | Pereira, Rosa M. | Silva, Clovis A. | Bonfa, Eloisa | Beckmann, Jessica | Bartholomä, Nora | Venhoff, Nils | Henneke, Philipp | Salzer, Ulrich | Janda, Ales | Boteanu, Alina Lucica | Corral, Sandra Garrote | Giraldo, Alberto Sifuentes | Gámir, Mariluz Gámir | Mendoza, Antonio Zea | Adrovic, Amra | Dedeoglu, Reyhan | Sahin, Sezgin | Barut, Kenan | Koka, Aida | Oztunc, Funda | Kasapcopur, Ozgur | Rodriguez-Lozano, Ana Luisa | Rivas-Larrauri, Francisco | de la Puente, Silvestre García | Alves, Andressa G. F. | Giacomin, Maria F. D. A. | Farhat, Juliana | Braga, Alfésio L. F. | Sallum, Adriana M. E. | Campos, Lúcia M. D. A. | Pereira, Luiz A. A. | Lichtenfels, Ana J. D. F. C. | Silva, Clóvis A. | Farhat, Sylvia C. L. | Acar, Banu | Ozcakar, Z. Birsin | Çakar, Nilgün | Uncu, Nermin | Gür, Gökçe | Özdel, Semanur | Yalçınkaya, Fatoş | Scott, Christiaan | Brice, Nicky | Nourse, Peter | Lewandowski, Laura | Arango, Christine | Mosquera, Angela C. | Malagon, Clara | Sakamoto, Ana P. | Silva, Clovis A. | Silva, Marco F. C. D. | Lopes, Ananadreia S. | Russo, Gleice C. S. | Sallum, Adriana E. M. | Kozu, Katia | Bonfá, Eloisa | Saad-Magalhães, Claudia | Pereira, Rosa M. R. | Len, Claudio A. | Terreri, Maria T. | Suri, Deepti | Didel, Siyaram | Rawat, Amit | Singh, Surjit | Maritsi, Despoina | Onoufriou, MArgarita | Vougiouka, Olga | Tsolia, Maria | Bosak, Edi Paleka | Vidović, Mandica | Lamot, Mirta | Lamot, Lovro | Harjaček, Miroslav | Van Nieuwenhove, Erika | Liston, Adrian | Wouters, Carine | Tahghighi, Fatemeh | Ziaee, Vahid | Raeeskarami, Seid-Reza | Aguiar, Francisca | Pereira, Sandra | Rodrigues, Mariana | Moura, Cláudia | Rocha, Gustavo | Guimarães, Hercília | Brito, Iva | Aguiar, Francisca | Fonseca, Rita | Rodrigues, Mariana | Brito, Iva | Horneff, Gerd | Klein, Ariane | Minden, Kirsten | Huppertz, Hans-Iko | Weller-Heinemann, Frank | Kuemmerle-Deschner, Jasmin | Haas, J-Peter | Hospach, Anton | Menendez-Castro, Ricardo | Huegle, Boris | Haas, Johannes-Peter | Swart, Joost | Giancane, Gabriella | Bovis, Francesca | Castagnola, Elio | Groll, Andreas | Horneff, Gerd | Huppertz, Hans-Iko | Lovell, Daniel J. | Wolfs, Tom | Hofer, Michael | Alekseeva, Ekaterina | Panaviene, Violeta | Nielsen, Susan | Anton, Jordi | Uettwiller, Florence | Stanevicha, Valda | Trachana, Maria | Marafon, Denise Pires | Ailioaie, Constantin | Tsitsami, Elena | Kamphuis, Sylvia | Herlin, Troels | Doležalová, Pavla | Susic, Gordana | Flatø, Berit | Sztajnbok, Flavio | Pistorio, Angela | Martini, Alberto | Wulffraat, Nico | Ruperto, Nicolino | Gattorno, Marco | Brucato, Antonio | Finetti, Martina | Lazaros, George | Maestroni, Silvia | Carraro, Mara | Cumetti, Davide | Carobbio, Alessandra | Lorini, Monia | Rimini, Alessandro | Marcolongo, Renzo | Valenti, Anna | Erre, Gian Luca | Belli, Riccardo | Gaita, Fiorenzo | Sormani, Maria Pia | Ruperto, Nicolino | Imazio, Massimo | Martini, Alberto | Abinun, Mario | Smith, Nicola | Rapley, Tim | McErlane, Flora | Kearsley-Fleet, Lianne | Hyrich, Kimme L. | Foster, Helen | Ruperto, Nicolino | Lovell, Daniel J. | Tzaribachev, Nikolay | Zeft, Andrew | Cimaz, Rolando | Stanevicha, Valda | Horneff, Gerd | Bohnsack, John | Griffin, Thomas | Carrasco, Ruy | Trachana, Maria | Dare, Jason | Foeldvari, Ivan | Vehe, Richard | Bovis, Francesca | Simon, Teresa | Martini, Alberto | Brunner, Hermine | Verazza, S. | Davì, S. | Consolaro, A. | Insalaco, A. | Gerloni, V. | Cimaz, R. | Zulian, F. | Pastore, S. | Corona, F. | Conti, G. | Barone, P. | Cattalini, M. | Cortis, E. | Breda, L. | Olivieri, A. N. | Civino, A. | Podda, R. | Rigante, D. | La Torre, F. | D’Angelo, G. | Jorini, M. | Gallizzi, R. | Maggio, M. C. | Consolini, R. | De Fanti, A. | Alpigiani, M. G. | Martini, A. | Ravelli, A. | Sozeri, Betul | Kısaarslan, Aysenur Pac | Gunduz, Zubeyde | Dusunsel, Ruhan | Dursun, Ismail | Poyrazoglu, Hakan | Kuchinskaya, Ekaterina | Abduragimova, Farida | Kostik, Mikhail | Sundberg, Erik | Omarsdottir, Soley | Klevenvall, Lena | Erlandsson-Harris, Helena | Basbozkurt, Gokalp | Erdemli, Ozge | Simsek, Dogan | Yazici, Fatih | Karsioglu, Yildirim | Tezcaner, Aysen | Keskin, Dilek | Ozkan, Huseyin | Acikel, Cengizhan | Ozen, Seza | Demirkaya, Erkan | Orbán, Ilonka | Sevcic, Krisztina | Brodszky, Valentin | Kiss, Emese | Tekko, Ismaiel A. | Rooney, Madeleine | McElnay, James | Taggart, Cliff | McCarthy, Helen | Donnelly, Ryan F. | Abinun, Mario | Slatter, Mary | Nademi, Zohreh | Friswell, Mark | Foster, Helen | Jandial, Sharmila | McErlane, Flora | Flood, Terence | Hambleton, Sophie | Gennery, Andrew | Cant, Andrew | Finetti, Martina | Bovis, Francesca | Swart, Joost | Doležalová, Pavla | Tsitsami, Elena | Trachana, Maria | Demirkaya, Erkan | Duong, Phoi-Ngoc | Koné-Paut, Isabelle | Vougiouka, Olga | Marafon, Denise Pires | Cimaz, Rolando | Filocamo, Giovanni | Gamir, María Luz | Stanevicha, Valda | Sanner, Helga | Carenini, Laura | Wulffraat, Nico | Martini, Alberto | Ruperto, Nicolino | Topdemir, Mesut | Basbozkurt, Gokalp | Karslioglu, Yildirim | Ozkan, Huseyin | Acikel, Cengizhan | Demirkaya, Erkan | Gok, Faysal | Zholobova, Elena | Tsurikova, Nadezhda | Ligostaeva, Elena | Ramchurn, Navdha R. | Friswell, Mark | Kostareva, O. | Nikishina, I. | Arsenyeva, S. | Rodionovskaya, S. | Kaleda, M. | Alexeev, D. | Dursun, Ismail Dursun | Sozeri, Betul | Kısaarslan, Aysenur Pac | Dusunsel, Ruhan | Poyrazoglu, Hakan | Poyrazoglu, Hakan | Murias, Sara | Barral, Estefania | Alcobendas, Rosa | Enriquez, Eugenia | Remesal, Agustin | de Inocencio, Jaime | Castro, Tania M. | Lotufo, Simone A. | Freye, Tatjana | Carlomagno, Raffaella | Zumbrunn, Thomas | Bonhoeffer, Jan | Schneider, Elvira Cannizzaro | Kaiser, Daniela | Hofer, Michaël | Hentgen, Véronique | Woerner, Andreas | Schwarz, Tobias | Klotsche, Jens | Niewerth, Martina | Horneff, Gerd | Haas, Johannes-Peter | Hospach, Anton | Huppertz, Hans-Iko | Ganser, Gerd | Minden, Kirsten | Jeyaratnam, Jerold | ter Haar, Nienke | Kasapcopur, Ozgur | Rigante, Donato | Dedeoglu, Fatma | Baris, Ezgi | Vastert, Sebastiaan | Wulffraat, Nico | Frenkel, Joost | Hausmann, Jonathan S. | Lomax, Kathleen G. | Shapiro, Ari | Durrant, Karen L. | Brogan, P. A. | Hofer, M. | Kuemmerle-Deschner, J. B. | Lauwerys, B. | Speziale, A. | Leon, K. | Wei, X. | Laxer, R. M. | Signa, Sara | Rusmini, Marta | Campione, Elena | Chiesa, Sabrina | Grossi, Alice | Omenetti, Alessia | Caorsi, Roberta | Viglizzo, Gianmaria | Martini, Alberto | Ceccherini, Isabella | Gattorno, Marco | Federici, Silvia | Frenkel, Joost | Ozen, Seza | Lachmann, Helen | Finetti, Martina | Martini, Alberto | Ruperto, Nicola | Gattorno, Marco | Federici, Silvia | Vanoni, Federica | Ozen, Seza | Hofer, Michaël | Frenkel, Joost | Lachmann, Helen | Martini, Alberto | Ruperto, Nicola | Gattorno, Marco | Gomes, Sonia Melo | Omoyinmi, Ebun | Arostegui, Juan I. | Gonzalez-Roca, Eva | Eleftheriou, Despina | Klein, Nigel | Brogan, Paul | Volpi, Stefano | Santori, Elettra | Picco, Paolo | Pastorino, Claudia | Caorsi, Roberta | Rice, Gillian | Tesser, Alessandra | Martini, Alberto | Crow, Yanick | Candotti, Fabio | Gattorno, Marco | Barut, Kenan | Sahin, Sezgin | Adrovic, Amra | Sinoplu, Ada B. | Yucel, Gozde | Pamuk, Gizem | Kasapcopur, Ozgur | Damian, Laura O. | Lazea, Cecilia | Sparchez, Mihaela | Vele, Paulina | Muntean, Laura | Albu, Adriana | Rednic, Simona | Lazar, Calin | Mendonça, Leonardo O. | Pontillo, Alessandra | Kalil, Jorge | Castro, Fabio M. | Barros, Myrthes T. | Pardeo, Manuela | Messia, Virginia | De Benedetti, Fabrizio | Insalaco, Antonella | Malighetti, Giorgia | Gorio, Chiara | Ricci, Francesca | Parissenti, Ilaria | Montesano, Paola | Bonafini, Barbara | Medeghini, Veronica | Cattalini, Marco | Giordano, Lucio | Zani, Giulia | Ferraro, Rosalba | Vairo, Donatella | Giliani, Silvia | Cattalini, Marco | Maggio, Maria Cristina | Luppino, Girolamo | Corsello, Giovanni | Fernandez, Maria Isabel Gonzalez | Montesinos, Berta Lopez | Vidal, Adriana Rodriguez | Gorospe, Juan I. Arostegui | Penades, Inmaculada Calvo | Rafiq, Nadia K. | Wynne, Karen | Hussain, Khalid | Brogan, Paul A. | Ang, Elizabeth | Ng, Nicholas | Kacar, Ayla | Gucenmez, Ozge Altug | Makay, Balahan | Unsal, Sevket Erbil | Sahin, Yasin | Barut, Kenan | Kutlu, Tufan | Cullu-Cokugras, Fugen | Sahin, Sezgin | Adrovic, Amra | Ayyildiz-Civan, Hasret | Kasapcopur, Ozgur | Erkan, Tulay | Abdawani, Reem | Al Zuhbi, Sana | Abdalla, Eiman | Russo, Ricardo A. | Katsicas, María M. | Caorsi, Roberta | Minoia, Francesca | Viglizzo, Gianmaria | Grossi, Alice | Chiesa, Sabrina | Picco, Paolo | Ravelli, Angelo | Gattorno, Marco | Bhattad, Sagar | Rawat, Amit | Gupta, Anju | Suri, Deepti | Pandiarajan, Vignesh | Nada, Ritambhra | Tiewsoh, Kaara | Hawkins, Philip | Rowczenio, Dorota | Singh, Surjit | Fingerhutova, Sarka | Franova, Jana | Prochazkova, Leona | Hlavackova, Eva | Dolezalova, Pavla | Evrengül, Havva | Yüksel, Selçuk | Doğan, Mustafa | Gürses, Dolunay | Evrengül, Harun | De Pauli, Silvia | Pastore, Serena | Bianco, Anna Monica | Severini, Giovanni Maria | Taddio, Andrea | Tommasini, Alberto | Salugina, Svetlana O. | Fedorov, Evgeny | Kamenets, Elena | Zaharova, Ekaterina | Kaleda, Maria | Salugina, Svetlana O. | Fedorov, Evgeny | Kamenets, Elena | Zaharova, Ekaterina | Kaleda, Maria | Sleptsova, Tatiana | Alexeeva, Ekaterina | Savostyanov, Kirill | Pushkov, Alexander | Bzarova, Tatyana | Valieva, Saniya | Denisova, Rina | Isayeva, Kseniya | Chistyakova, Evgeniya | Lomakina, Olga | Soloshenko, Margarita | Kaschenko, Elena | Kaneko, Utako | Imai, Chihaya | Saitoh, Akihiko | Teixeira, Vitor A. | Ramos, Filipa O. | Costa, Manuela | Aviel, Yonatan Butbul | Fahoum, Shafe | Brik, Riva | Özçakar, Zeynep Birsin | Çakar, Nilgün | Uncu, Nermin | Celikel, Banu Acar | Yalcinkaya, Fatos | Schiappapietra, Benedetta | Davi’, Sergio | Mongini, Federica | Giannone, Luisa | Bava, Cecilia | Alpigiani, Maria Giannina | Martini, Alberto | Ravelli, Angelo | Consolaro, Alessandro | Lazarevic, Dragana S. | Vojinovic, Jelena | Susic, Gordana | Basic, Jelena | Giancane, Gabriella | Muratore, Valentina | Marzetti, Valentina | Quilis, Neus | Benavente, Belen Serrano | Alongi, Alessandra | Civino, Adele | Quartulli, Lorenzo | Consolaro, Alessandro | Martini, Alberto | Ravelli, Angelo | Januskeviciute, Giedre | van Dijkhuizen, Pieter | Muratore, Valentina | Giancane, Gabriella | Schiappapietra, Benedetta | Martini, Alberto | Ravelli, Angelo | Consolaro, Alessandro | Groot, N. | van Dijk, W. | Bultink, I. E. M. | Bijl, M. | Dolhain, R. J. E. M. | Teng, Y. K. O. | Zirkzee, E. | de Leeuw, K. | Fritsch-Stork, R. | Kamphuis, S. S. M. | Groot, Noortje | Kardolus, A. | Bultink, I. E. M. | Bijl, M. | Dolhain, R. J. E. M. | Teng, Y. K. O. | Zirkzee, E. | de Leeuw, K. | Fritsch-Stork, R. | Kamphuis, S. S. M. | Suárez, Raul Gutiérrez | Nordal, Ellen B. | Rypdal, Veronika G. | Berntson, Lillemor | Ekelund, Maria | Aalto, Kristiina | Peltoniemi, Suvi | Zak, Marek | Nielsen, Susan | Glerup, Mia | Herlin, Troels | Arnstad, Ellen D. | Fasth, Anders | Rygg, Marite | Duarte, Ana Catarina | Sousa, Sandra | Teixeira, Lídia | Cordeiro, Ana | Santos, Mª José | Mourão, Ana Filipa | Santos, Maria José | Eusébio, Mónica | Lopes, Ana | Oliveira-Ramos, Filipa | Salgado, Manuel | Estanqueiro, Paula | Melo-Gomes, José | Martins, Fernando | Costa, José | Furtado, Carolina | Figueira, Ricardo | Brito, Iva | Branco, Jaime C. | Fonseca, João E. | Canhão, Helena | Mourão, Ana F. | Santos, Maria Jose | Eusébio, Mónica | Lopes, Ana | Oliveira-Ramos, Filipa | Salgado, Manuel | Estanqueiro, Paula | Melo-Gomes, José | Martins, Fernando | Costa, José | Furtado, Carolina | Figueira, Ricardo | Brito, Iva | Branco, Jaime C. | Fonseca, João E. | Canhão, Helena | Coda, Andrea | Cassidy, Samuel | West, Kerry | Hendry, Gordon | Grech, Debra | Jones, Julie | Hawke, Fiona | Grewal, Davinder Singh | Coda, Andrea | Jones, Julie | Grech, Debra | Grewal, Davinder Singh | Foley, Charlene | Killeen, Orla | MacDermott, Emma | Veale, Douglas | Fearon, Ursula | Konukbay, Dilek | Demirkaya, Erkan | Tarakci, Ela | Arman, Nilay | Barut, Kenan | Şahin, Sezgin | Adrovic, Amra | Kasapcopur, Ozgur | Munro, Jane | Consolaro, Alessandro | Morgan, Esi | Riebschleger, Meredith | Horonjeff, Jennifer | Strand, Vibeke | Bingham, Clifton | Collante, Ma. Theresa M. | Ganeva, Margarita | Stefanov, Stefan | Telcharova, Albena | Mihaylova, Dimitrina | Saraeva, Radoslava | Tzveova, Reni | Kaneva, Radka | Tsakova, Adelina | Temelkova, Katya | Picarelli, Maria Mercedes C. | Danzmann, Luiz C. | Barbé-Tuana, Florencia | Grun, Lucas K. | Jones, Marcus H. | Frković, Marijan | Ištuk, Karla | Birkić, Ika | Sršen, Saša | Jelušić, Marija | Smith, Nicola | Jandial, Sharmila | Easton, Alan | Quarmby, Rachael | Khubchandani, Raju | Chan, Mercedes | Rapley, Tim | Foster, Helen | Srp, Radoslav | Kobrova, Katerina | Franova, Jana | Fingerhutova, Sarka | Nemcova, Dana | Hoza, Jozef | Uher, Michal | Saifridova, Melania | Linkova, Lenka | Dolezalova, Pavla | Charuvanij, Sirirat | Leelayuwattanakul, Isree | Pacharapakornpong, Thita | Vallipakorn, Sakda A.-O. | Lerkvaleekul, Butsabong | Vilaiyuk, Soamarat | Muratore, Valentina | Giancane, Gabriella | Lanni, Stefano | Alongi, Alessandra | Alpigiani, Maria Giannina | Martini, Alberto | Ravelli, Angelo | Consolaro, Alessandro | Alongi, Alessandra | Bovis, Francesca | Minoia, Francesca | Davì, Sergio | Martini, Alberto | Ruperto, Nicolino | Cron, Randy Q. | Ravelli, Angelo | Passarelli, Chiara | Pardeo, Manuela | Pisaneschi, Elisa | Novelli, Antonio | De Benedetti, Fabrizio | Bracaglia, Claudia | Bracaglia, Claudia | Marafon, Denise Pires | Caiello, Ivan | de Graaf, Kathy | Guilhot, Florence | Ferlin, Walter | Davi’, Sergio | Schulert, Grant | Ravelli, Angelo | Grom, Alexi A. | Nelson, Robert | de Min, Cristina | De Benedetti, Fabrizio | Holzinger, Dirk | Kessel, Christoph | Fall, Ndate | Grom, Alexei | de Jager, Wilco | Vastert, Sebastiaan | Strippoli, Raffaele | Bracaglia, Claudia | Sundberg, Erik | Horne, Anna | Ehl, Stephan | Ammann, Sandra | Lehmberg, Kai | De Benedetti, Fabrizio | Beutel, Karin | Foell, Dirk | Minoia, Francesca | Horne, AnnaCarin | Bovis, Francesca | Davì, Sergio | Pagani, Laura | Espada, Graciela | Gao, Yi-jin | Insalaco, Antonella | Lehmberg, Kai | Sanner, Helga | Shenoi, Susan | Weitzman, Sheila | Ruperto, Nicolino | Martini, Alberto | Cron, Randy Q. | Ravelli, Angelo | Prencipe, Giusi | Caiello, Ivan | Pascarella, Antonia | Bracaglia, Claudia | Ferlin, Walter G. | Chatel, Laurence | Strippoli, Raffaele | de Min, Cristina | De Benedetti, Fabrizio | Jacqmin, Philippe | De Graaf, Kathy | Ballabio, Maria | Nelson, Robert | Johnson, Zoë | Ferlin, Walter | Lapeyre, Geneviève | de Benedetti, Fabrizio | Cristina, de Min | Wakiguchi, Hiroyuki | Hasegawa, Shunji | Hirano, Reiji | Okazaki, Fumiko | Nakamura, Tamaki | Kaneyasu, Hidenobu | Ohga, Shouichi | Yamazaki, Kazuko | Nozawa, Tomo | Kanetaka, Taichi | Ito, Shuichi | Yokota, Shumpei | McLellan, Kirsty | MacGregor, Ishbel | Martin, Neil | Davidson, Joyce | Kuemmerle-Deschner, Jasmin | Hansmann, Sandra | Wulffraat, Nico | Eikelberg, Andreas | Haug, Iris | Schuller, Sabrina | Benseler, Susanne M. | Nazarova, Liliia S. | Danilko, Kseniia V. | Malievsky, Viktor A. | Viktorova, Tatiana V. | Mauro, Angela | Omoyinmi, Ebun | Barnicoat, Angela | Brogan, Paul | Foley, Charlene | Killeen, Orla | MacDermott, Emma | Veale, Douglas | Foley, Charlene | Killeen, Orla | MacDermott, Emma | Veale, Douglas | Gomes, Sonia Melo | Omoyinmi, Ebun | Hurst, Jane | Canham, Nathalie | Eleftheriou, Despina | Klein, Nigel | Lacassagne, Sandrine | Brogan, Paul | Wiener, Anastasia | Hügle, Boris | Denecke, Bernd | Costa-Filho, Ivan | Haas, Johannes Peter | Tenbrock, Klaus | Popp, David | Boltjes, Arjan | Rühle, Frank | Herresthal, Stefanie | de Jager, Wilco | van Wijk, Femke | Schultze, Joachim | Stoll, Monika | Klotz, Luisa | Vogl, Thomas | Roth, Johannes | Quesada-Masachs, Estefania | de la Sierra, Daniel Álvarez | Prat, Marina Garcia | Sánchez, Ana M. Marín | Borrell, Ricardo Pujol | Barril, Sara Marsal | Gallo, Mónica Martínez | Caballero, Consuelo Modesto | Chyzheuskaya, Iryna | Byelyaeva, Lyudmyla M. | Filonovich, Rostislav M. | Khrustaleva, Helena K. | Zajtseva, Larisa I. | Yuraga, Tamara M. | Chyzheuskaya, Iryna | Byelyaeva, Lyudmyla M. | Filonovich, Rostislav M. | Khrustaleva, Helena K. | Zajtseva, Larisa I. | Yuraga, Tamara M. | Giner, Thomas | Hackl, Lukas | Albrecht, Julia | Würzner, Reinhard | Brunner, Juergen | Pastore, Serena | Minute, Marta | Parentin, Fulvio | Tesser, Alessandra | Nocerino, Agostino | Taddio, Andrea | Tommasini, Alberto | Nørgaard, Mette | Herlin, Troels | Alberdi-Saugstrup, Mikel | Zak, Marek S. | Nielsen, Susan M. | Herlin, Troels | Nordal, Ellen | Berntson, Lillemor | Fasth, Anders | Rygg, Marite | Müller, Klaus G. | Avramovič, Mojca Zajc | Dolžan, Vita | Toplak, Nataša | Avčin, Tadej | Ruperto, N. | Lovell, D. J. | Wallace, C. | Toth, M. | Foeldvari, I. | Bohnsack, J.
PMCID: PMC5461533
6.  Clinical Presentation and Time-Based Mortality in Patients With Chest Injuries Associated With Road Traffic Accidents 
Archives of Trauma Research  2016;5(1):e31888.
Blunt chest trauma (BCT) poses significant morbidity and mortality worldwide.
We investigated the clinical presentation and outcome of BCT related to road traffic accidents (RTA).
Patients and Methods:
A retrospective observational analysis for patients who sustained BCT secondary to RTA in terms of motor vehicle crash (MVC) and pedestrian-motor vehicle accidents (PMVA) who were admitted to the trauma center at Hamad general hospital, Doha, Qatar, between 2008 and 2011.
Of 5118 traumatic injury cases, 1004 (20%) were found to have BCT secondary to RTA (77% MVC and 23% PMVA). The majority were males (92%), and expatriates (72%). Among MVCs, 84% reported they did not use protective devices. There was a correlation between chest abbreviated injury score (AIS) and injury severity scoring (ISS) (r = 0.35, r2 = 0.12, P < 0.001). Regardless of mechanism of injury (MOI), multivariate analysis showed that the head injury associated with chest AIS and ISS was a predictor of mortality in BCT. Overall mortality was 15%, and the highest rate was observed within the first 24 hours post-trauma.
Blunt chest trauma from RTA represents one-fifth of the total trauma admissions in Qatar, with a high overall mortality. Pedestrians are likely to have more severe injuries and higher fatality rates than MVC victims. Specific injury prevention programs focusing on road safety should be implemented to minimize the incidence of such preventable injuries.
PMCID: PMC4853503  PMID: 27148499
Chest Trauma; Road Traffic Accidents; Injury; Pedestrians; Motor Vehicle Crashes
7.  Liver stiffness measurement and spleen diameter as predictors for the presence of esophageal varices in chronic hepatitis C patients 
Medicine  2017;96(46):e8621.
Although it is an invasive and unpleasant procedure, esophagogastroduodenoscopy (EGD) is still the gold standard for esophageal varices (EV) detection. The aim of this study was to investigate liver stiffness measurement (LSM) and spleen diameter as simple noninvasive tools for EV prediction in chronic hepatitis C patients (CHC).
A total of 123 Egyptian patients with CHC have been included and were classified based on screening EGD result into 2 groups; group A (without EV) and group B (with EV). Group (B) was subclassified according to EV grade into 4 subgroups: (B1, grade I), (B2, grade II), (B3, grade III), and (B4, grade IV). LSM was taken for each patient on the next day by an independent Fibroscan operator and correlated to the EGD result. Demographic, clinical, and biochemical data were recorded and analyzed using advanced data-mining computational technology.
Mean LSM was 9.94 ± 6 kPa for group A and 33.32 ± 14 kPa for group B, whereas it was 21.22 ± 3, 25.72 ± 6, 33.82 ± 8, and 46.1 ± 15 kPa for subgroups B1, B2, B3, and B4, respectively. Mean spleen diameter was 11.09 ± 1.7 cm for group A and 16.58 ± 1.6 cm for group B. However, LSM ≥17 kPa was the only independent factor for EV prediction; splenic longitudinal span ≥15 cm was a complementary predictor when LSM was <17 kPa. The overall accuracy was 98.33 ± 3.33, Mikro = 98.26%.
LSM ≥17 kPa and spleen diameter ≥15 cm is a simple noninvasive algorithm that could be used for prediction of EV and discrimination among its different grades.
PMCID: PMC5704825  PMID: 29145280
data mining; esophageal varices; Fibroscan; splenic diameter; Ttransient elastography
8.  Bacteriological profiling of diphenylureas as a novel class of antibiotics against methicillin-resistant Staphylococcus aureus 
PLoS ONE  2017;12(8):e0182821.
Bacterial resistance to antibiotics remains an imposing global public health challenge. Of the most serious pathogens, methicillin-resistant Staphylococcus aureus (MRSA) is problematic given strains have emerged that exhibit resistance to several antibiotic classes including β-lactams and agents of last resort such as vancomycin. New antibacterial agents composed of unique chemical scaffolds are needed to counter this public health challenge. The present study examines two synthetic diphenylurea compounds 1 and 2 that inhibit growth of clinically-relevant isolates of MRSA at concentrations as low as 4 µg/mL and are non-toxic to human colorectal cells at concentrations up to 128 μg/mL. Both compounds exhibit rapid bactericidal activity, completely eliminating a high inoculum of MRSA within four hours. MRSA mutants exhibiting resistance to 1 and 2 could not be isolated, indicating a low likelihood of rapid resistance emerging to these compounds. Bacterial cytological profiling revealed the diphenylureas exert their antibacterial activity by targeting bacterial cell wall synthesis. Both compounds demonstrate the ability to resensitize vancomycin-resistant Staphylococcus aureus to the effect of vancomycin. The present study lays the foundation for further investigation and development of diphenylurea compounds as a new class of antibacterial agents.
PMCID: PMC5552351  PMID: 28797064
9.  Correlation of central venous pressure with venous blood gas analysis parameters; a diagnostic study 
This study was conducted to assess the correlation between central venous pressure (CVP) and venous blood gas (VBG) analysis parameters, to facilitate management of severe sepsis and septic shock in emergency department.
Material and methods
This diagnostic study was conducted from January 2014 until June 2015 in three major educational medical centers, Tehran, Iran. For patients selected with diagnosis of septic shock, peripheral blood sample was taken for testing the VBG parameters and the anion gap (AG) was calculated. All the mentioned parameters were measured again after infusion of 500 cc of normal saline 0.9% in about 1 h.
Totally, 93 patients with septic shock were enrolled, 63 male and 30 female. The mean age was 72.53 ± 13.03 and the mean Shock Index (SI) before fluid therapy was 0.79 ± 0.30. AG and pH showed significant negative correlations with CVP, While HCO3 showed a significant positive correlation with CVP. These relations can be affected by the treatment modalities used in shock management such as fluid therapy, mechanical ventilation and vasopressor treatment.
It is likely that there is a significant statistical correlation between VBG parameters and AG with CVP, but further research is needed before implementation of the results of this study.
PMCID: PMC5357094
Shock; Septic; Central venous pressure; Blood gas analysis; Emergency department; Emergency medicine
10.  The “Triple-Q Algorithm:” A practical approach to the identification of liver topography 
The descriptive identification and interpretation of liver pathology continue to raise debate, especially for trainees and junior physicians. There is wide diversity in the description of liver segmentation with sometimes contradictory terminology between French and American literature. Attempts were made to create a unified nomenclature that simplifies the problem. We propose a simple approach to describe the location of liver pathology in different settings by referring to an algorithm based on three questions. Explanations to answer these questions and correctly describe the location of liver pathology are herein described. In conclusion, we think that the adoption of such an algorithm called arbitrary “the Triple-Q Algorithm” will facilitate the understanding of liver topography for the young physicians, as well as it will allow for the accurate description and localization of the pathological lesions in the liver. This could be achieved after testing and validating this algorism in prospective studies. This could have academic and clinical implications in the medical education and the patient care.
PMCID: PMC5108097  PMID: 27857888
Hepatic topography; liver segmentation; nomenclature of liver anatomy
11.  Synthesis and antibacterial evaluation of a novel series of synthetic phenylthiazole compounds against methicillin-resistant Staphylococcus aureus (MRSA) 
Methicillin-resistant Staphylococcus aureus infections are a significant global health challenge in part due to the emergence of strains exhibiting resistance to nearly all classes of antibiotics. This underscores the urgent need for the rapid development of novel antimicrobials to circumvent this burgeoning problem. Previously, whole-cell screening of a library of 2,5-disubstituted thiazole compounds revealed a lead compound exhibiting potent antimicrobial activity against MRSA. The present study, conducting a more rigorous analysis of the structure-activity relationship of this compound, reveals a nonpolar, hydrophobic functional group is favored at thiazole-C2 and an ethylidenehydrazine-1-carboximidamide moiety is necessary at C5 for the compound to possess activity against MRSA. Furthermore, the MTS assay confirmed analogues 5, 22d, and 25 exhibited an improved toxicity profile (not toxic up to 40 μg/mL to mammalian cells) over the lead 1. Analysis with human liver microsomes revealed compound 5 was more metabolically stable compared to the lead compound (greater than eight-fold improvement in the half-life in human liver microsomes). Collectively the results presented demonstrate the novel thiazole derivatives synthesized warrant further exploration for potential use as future antimicrobial agents for the treatment of multidrug-resistant S. aureus infections.
PMCID: PMC4716659  PMID: 25771109
Antimicrobials; Drug-resistance; Methicillin-resistant Staphylococcus aureus (MRSA); Thiazole compounds; HEK293 Toxicity
12.  Anti-biofilm activity and synergism of novel thiazole compounds with glycopeptide antibiotics against multidrug-resistant staphylococci 
The Journal of antibiotics  2014;68(4):259-266.
Methicillin-resistant Staphylococcus aureus (MRSA) infections are a leading cause of death among all fatalities caused by antibiotic-resistant bacteria. With the rise of increasing resistance to current antibiotics, new antimicrobials and treatment strategies are urgently needed. Thiazole compounds have been shown to possess potent antimicrobial activity. A lead thiazole 1 and a potent derivative 2 were synthesized and their activity in combination with glycopeptide antibiotics was determined against an array of MRSA and vancomycin-resistant Staphylococcus aureus (VRSA) clinical isolates. Additionally, the anti-biofilm activity of the novel thiazoles was investigated against Staphylococcus epidermidis. Compound 2 behaved synergistically with vancomycin against MRSA and was able to re-sensitize VRSA to vancomycin, reducing its minimum inhibitory concentration (MIC) by 512-fold in two strains. Additionally, both thiazole compounds were superior to vancomycin in significantly reducing S. epidermidis biofilm mass. Collectively the results obtained demonstrate compounds 1 and 2 possess potent antimicrobial activity alone or in combination with vancomycin against multidrug-resistant staphylococci and show potential for use in disrupting staphylococcal biofilm.
PMCID: PMC4429288  PMID: 25315757
Antimicrobials; Biofilm disruption; Combination therapy; Drug-resistance; Methicillin-resistant Staphylococcus aureus (MRSA); Re-sensitization; Thiazole compounds
13.  Bariatric Bypass Surgery to Resolve Complicated Childhood Morbid Obesity 
Medicine  2015;94(49):e2221.
Supplemental Digital Content is available in the text
Children obesity has become one of the most important public health problems in many countries worldwide. Although the awareness of childhood obesity as a modifiable health risk is high, but many societies do not prioritize this issue as a health care problem, which may lead to comorbidities and even premature death. Despite the rising interest in bariatric surgery for children, only laparoscopic sleeve gastrectomy (LSG) is being considered in resolving childhood obesity who failed other dietary or drug therapies; however many of LSG procedures failed to reduce the weight in children or resulted in complications postsurgery.
Here, we present a novel bariatric procedure to clue out a female child 13 years old presented with Legg–Calvé–Perthes disease-associated morbid obesity. The surgical bariatric technique applied both fundal resection and surgical bypass in pediatric obesity using the Elbanna novel bariatric technique.
Bariatric surgical bypass may be considered in complicated-childhood cases who failed all other options.
PMCID: PMC5008506  PMID: 26656361
14.  Patterns and outcomes of traumatic neck injuries: A population-based observational study 
We aimed to analyze the pattern and outcome of traumatic neck injury (TNI) in a small population.
Materials and Methods:
It is a retrospective analysis of all TNI patients who were admitted to the trauma center between 2008 and 2012. Patients’ demographics, details of TNI, associated injuries, hospital course, and mortality were analyzed.
A total of 51 TNI cases were included revealing an overall incidence of 0.61/100,000 population. The mean age was 31 ± 9 years. The most frequent mechanism of injury was motor vehicle crash (29.4%) followed by stab (17.6%), machinery injury (17.6%), fall (9.8%), and assault (7.8%). Larynx, thyroid gland, trachea, jugular veins, and carotid were the commonly injured structures. The majority of cases had Zone II TNI whereas isolated injury was observed in 11 cases. TNI were mainly presented with active bleeding (38%), hypovolemic shock (16%) and respiratory distress (16%). Surgical interventions mainly included simple repair and closure (53%), vein ligation (12%), repair of major arteries (4%), tracheal repair (6%), larynx and hypopharynx repair (4%), and repair of parotid gland (2%). Neck exploration was performed in 88%, and emergency tracheostomy was required in 18% of cases. Overall mortality rate was 11.8%, of which five patients had associated injuries, and one had isolated TNI.
TNI are not frequent but represent an alarming serious entity in Qatar. Patients with persistent signs of major injuries should undergo early operative interventions. Moreover, the effective injury prevention program should be developed to minimize these preventable injuries in the majority of cases.
PMCID: PMC4520029  PMID: 26229299
Complications; management; neck injury; outcome; trauma
15.  Antibacterial Characterization of Novel Synthetic Thiazole Compounds against Methicillin-Resistant Staphylococcus pseudintermedius 
PLoS ONE  2015;10(6):e0130385.
Staphylococcus pseudintermedius is a commensal organism of companion animals that is a significant source of opportunistic infections in dogs. With the emergence of clinical isolates of S. pseudintermedius (chiefly methicillin-resistant S. pseudintermedius (MRSP)) exhibiting increased resistance to nearly all antibiotic classes, new antimicrobials and therapeutic strategies are urgently needed. Thiazole compounds have been previously shown to possess potent antibacterial activity against multidrug-resistant strains of Staphylococcus aureus of human and animal concern. Given the genetic similarity between S. aureus and S. pseudintermedius, this study explores the potential use of thiazole compounds as novel antibacterial agents against methicillin-sensitive S. pseudintermedius (MSSP) and MRSP. A broth microdilution assay confirmed these compounds exhibit potent bactericidal activity (at sub-microgram/mL concentrations) against both MSSA and MRSP clinical isolates while the MTS assay confirmed three compounds (at 10 μg/mL) were not toxic to mammalian cells. A time-kill assay revealed two derivatives rapidly kill MRSP within two hours. However, this rapid bactericidal activity was not due to disruption of the bacterial cell membrane indicating an alternative mechanism of action for these compounds against MRSP. A multi-step resistance selection analysis revealed compounds 4 and 5 exhibited a modest (two-fold) shift in activity over ten passages. Furthermore, all six compounds (at a subinihibitory concentration) demonstrated the ability to re-sensitize MRSP to oxacillin, indicating these compounds have potential use for extending the therapeutic utility of β-lactam antibiotics against MRSP. Metabolic stability analysis with dog liver microsomes revealed compound 3 exhibited an improved physicochemical profile compared to the lead compound. In addition to this, all six thiazole compounds possessed a long post-antibiotic effect (at least 8 hours) against MRSP. Collectively the present study demonstrates these synthetic thiazole compounds possess potent antibacterial activity against both MSSP and MRSP and warrant further investigation into their use as novel antimicrobial agents.
PMCID: PMC4472782  PMID: 26086336
16.  Discovery and Characterization of Potent Thiazoles versus Methicillin- and Vancomycin-Resistant Staphylococcus aureus 
Journal of medicinal chemistry  2014;57(4):1609-1615.
Methicillin- and vancomycin-resistant Staphylococcus aureus (MRSA & VRSA) infections are growing global health concerns. Structure-activity-relationships of phenylthiazoles as a new antimicrobial class have been addressed. We present 10 thiazole derivatives that exhibit strong activity against 18 clinical strains of MRSA and VRSA with acceptable PK profile. Three derivatives revealed an advantage over vancomycin by rapidly eliminating MRSA growth within six hours and no derivatives are toxic to HeLa cells at a concentration of 11 μg/mL.
PMCID: PMC4353699  PMID: 24387054
17.  Traumatic injury among females: does gender matter? 
Trauma remains one of the leading causes of morbidity and mortality worldwide. Generally, the incidence of traumatic injuries is disproportionately high in males. However, trauma in females is underreported.
To study the epidemiology and outcome of different mechanisms and types of traumatic injuries in women.
We conducted a traditional narrative review using PubMed, MEDLINE and EMBASE, searching for English-language publications for gender-specific trauma between January 1993 and January 2013 using key words “trauma”, “gender”, “female” and “women”.
Among 1150 retrieved articles, 71 articles were relevant over 20 years. Although it is an important public health problem, traumatic injuries among females remain under-reported.
There is a need for further research and evaluation of the exact burden of traumatic injuries among females together with the implementation of effective community based preventive programs.
PMCID: PMC4118222  PMID: 25089153
Trauma; Gender; Injury mechanisms; Female
18.  Blunt traumatic injury in the Arab Middle Eastern populations 
Trauma represents a global public health concern with an estimated 5 million deaths annually. Moreover, the incidence of blunt traumatic injuries (BTI) particularly road traffic accidents (RTAs) and workplace-related injuries are rising throughout the world-wide. Objectives: We aimed to review the epidemiology and prevention of BTI, in the Arab Middle East.
Materials and Methods:
A traditional narrative literature review was carried out using PubMed, MEDLINE and EMBASE search engines. We used the keywords “traumatic injuries”, “blunt” “epidemiology”, “Arab Middle East” between December 1972 and March 2013.
The most common mechanisms of BTI in our region are RTAs, falls from height, struck by heavy objects and pedestrian motor vehicle trauma crashes. The rate of RTA and occupational injuries are markedly increased in the region due to rapid industrial development, extreme climatic conditions and unfamiliar working environment. However, lack of reliable information on these unintentional injuries is mainly responsible for the underestimation of this trauma burden. This knowledge deficit shields the extent of the problem from policy makers, leading to continued fatalities. These preventable injuries in turn add to the overall financial burden on the society through loss of productivity and greater need of medical and welfare services.
In the Arab Middle East, population-based studies on the incidence, mechanism of injury, prevention and outcome of BTI are not well-documented. Therefore, region-specific BTI studies would strengthen surveillance to better understand the burden of these injuries in the region.
PMCID: PMC4013743  PMID: 24812453
Arab Middle East; blunt traumatic injuries; fall; pedestrians; road traffic accident
19.  Workplace-Related Traumatic Injuries: Insights from a Rapidly Developing Middle Eastern Country 
Traumatic workplace-related injuries (WRIs) carry a substantial negative impact on the public health worldwide. We aimed to study the incidence and outcomes of WRIs in Qatar. We conducted occupational injury surveillance for all WRI patients between 2010 and 2012. A total of 5152 patients were admitted to the level 1 trauma unit in Qatar, of which 1496 (29%) sustained WRI with a mean age of 34.3 ± 10.3. Fall from height (FFH) (51%) followed by being struck by heavy objects (FHO) (18%) and motor vehicle crashes (MVC) (17%) was the commonest mechanism of injury (MOI). WRI patients were mainly laborers involved in industrial work (43%), transportation (18%), installation/repair (12%), carpentry (9%), and housekeeping (3%). Use of protective device was not observed in 64% of cases. The mean ISS was 11.7 ± 8.9, median ICU stay was 3 days (1–64), and total hospital stay was 6 days (1–192). The overall case fatality was 3.7%. Although the incidence of WRI in Qatar is quite substantial, its mortality rate is relatively low in comparison to other countries of similar socioeconomic status. Prolonged hospital stay and treatment exert a significant socioeconomic burden on the nation's and families' resources. Focused and efficient injury prevention strategies are mandatory to prevent future WRI.
PMCID: PMC3964690  PMID: 24734049

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