Background: Beta- lactam resistant Escherichia coli is a major cause of both nosocomial and community-acquired infections. It is essential to detect the beta lactam resistance for proper antibiotic therapy and to limit the spread the infection. Objectives: The study was designed to review the rates of extended-spectrum β-lactamases (ESBL), metallo beta lactamases (MBL) beta lactamase and AmpC production among E.coli isolates and to assess the best phenotypic method for detection of the resistance. Methodology: This study included 200 isolates obtained from patients admitted to different departments in Assiut university hospital .Screening and phenotypic confirmatory tests for resistance were done. Results: The Percentages of B –Lactamase enzymes in 5o isolates of E.coli were 6 (12%) isolates not resistant by screening with antibiotic sensitivity tests, 3 (6%) isolates were negative by the gold standard phenotypic tests, 12 (24%) were ESBL alone, 2 (4%) were ESBL and AmpC, 10 (20%) were AmpC alone, 8 (16%) were ESBL and Carbapenemases and 9 (18%) were carbapenemases alone. The combined disk test showed high sensitivity and specificity in detection of ESBL and MB, For AmpC detection; the disk approximation test showed higher sensitivity and specificity than boronic acid in detection of AmpC. Conclusion: The rate of Beta lactamases production in E.coli is seriously increased, the ESBL showed the highest percentage among E.coli isolates. The phenotypic confirmatory tests showed high sensitivity and specificity and proved to be reliable methods for detection of the beta lactamase resistance, genotypic tests are recommended to be a gold standard tests to increase the specificity of the phenotypic tests.

ABSTRACT
This research paper presents the epidemiological data and clinical manifestations of blood parasitic infections in cattle. A total of 130 blood samples were collected from animals exhibiting clinical signs suggestive of blood parasitic infection. Microscopic examination of blood smears revealed an overall infection rate of 46.2% among the examined cattle. Theileria sp. infections were found to be the most prevalent, with an overall prevalence of 40%. Babesia sp. infections had a lower overall prevalence of 6.2%, Microscopic examination also highlighted the intracellular localization of Theileria and Babesia parasites within red blood cells. The infected red blood cells exhibited morphological changes, appearing enlarged and distorted compared to unaffected cells. The study analyzed the risk factors for Theileria sp. and Babesia sp. infections in cattle, specifically focusing on age and gender. The prevalence of Theileria sp. infection was highest in cattle less than one year, with no significant difference observed among different age groups or genders. Similarly, there was no significant difference in Babesia sp. infection rates based on age or gender. These results provide valuable insights into the epidemiology and clinical manifestations of blood parasitic infections in cattle. The findings can contribute to the development of effective control and prevention strategies, highlighting the importance of regular surveillance and management practices in mitigating the impact of these infections on cattle health and productivity.
Keywords: Microscopic examination, Blood smears, Theileria sp., Babesia sp., Risk factors

Among the secondary causes of pediatric hypertension, endocrine causes account for a relatively small proportion of all children with hypertension. An accurate diagnosis of endocrine hypertension offers clinicians the chance to achieve an optimal treatment with either specific pharmacologic treatment or surgery. Excess catecholamine, glucocorticoids, and mineralocorticoids, congenital adrenal hyperplasia, thyroid dysfunction, growth hormone deficiency, diabetes mellitus, and obesity-associated hypertension are the major endocrine disorders leading to pediatric hypertension.

Graves’ disease (GD) is the most common cause of hyperthyroidism in children. A common GD symptom is a goiter. The usual biochemical profile in children with GD is a decreased thyroid hormone stimulating hormone (TSH) level and high free thyroxine (FT4) and free triiodothyronine (FT3) concentrations. The presence of thyroid receptor antibodies (TRAb) is the most important specific immunological sign for diagnosing GD. The treatment choices for pediatric GD are anti-thyroid drugs (ATDs), radioiodine, and thyroidectomy, but the risks and benefits of each modality are different. Management recommendations include the first-line use of a prolonged course of ATDs for at least 3 years and potentially 5 years or more. Rituximab and Teprotumumab are new novel alternative medications for the treatment of adult patients with GD and Graves’ orbitopathy respectively, but evidence of the efficacy and safety of …

Intravenous dexmedetomidine (DEX) is currently approved by the FDA for the sedation of intubated patients in intensive care units to reduce anxiety and to augment postoperative analgesia. Bradycardia and hypotension are limitations associated with the intravenous administration of DEX. In this study, DEX sublingual in situ gels were developed and assessed for their pH, gelling capacity, viscosity, mucoadhesion and in vitro drug release. The optimized gelling system demonstrated enhanced mucoadhesion, superior gelling capacity, reasonable pH and optimal rheological profile. In vivo, compared to the oral solution, the optimal sublingual gel resulted in a significant higher rate and extent of bioavailability. Although the in situ gel had comparable plasma levels to those observed following intravenous administration, significant amelioration of the systemic adverse reactions were attained. As demonstrated by the hot plate method, a sustained duration of analgesia in rats was observed after sublingual administration of DEX gel compared to the intravenously administered DEX solution. Furthermore, no changes in systolic blood pressure and heart rate were recorded in rats and rabbits, respectively, after sublingual administration of DEX. Sublingual administration of DEX in situ gel provides a promising approach for analgesia and sedation, while circumventing the reported adverse reactions associated with intravenous administration of DEX.

Several Laser in-situ keratomileusis (LASIK) complications have been identified over the years. Reporting complications of LASIK surgery will help refine the approach to their management. LASIK was introduced in the late 1980s with the development of the ophthalmic excimer laser [1, 2]. To avoid the disadvantages of photorefractive keratectomy (PRK), LASIK was introduced [3]. LASIK rapidly increased in popularity and became the predominant form of refractive surgery in the late 1990s and continues till today [4]. Correcting different refractive errors, including myopia, hyperopia, and astigmatism, is the main aim of all laser refractive procedures. LASIK has been used to treat many degrees of myopia with promising results, and there are great expectations for treating farsightedness. Compared to PRK, LASIK is advantageous in causing minimal postoperative discomfort, rapid restoration of visual clarity and stability of refractive changes, less frequent opacification, and better ability to correct high levels of myopia. Intraoperative complications, although infrequent, include Microkeratome-related flap complications (flap buttonhole, free cap, and incomplete, short, or irregular flaps), corneal perforation, corneal epithelial defect, conjunctival bleeding, subconjunctival hemorrhage, and interface debris [6]. Post-operative Complications include inaccurate correction, visual aberrations, flap striae (macrostriae -microstriae) [6], flap dislocation, dry eye, diffuse lamellar keratitis (DLK), pressure-induced stromal keratitis (PISK), infectious keratitis [7], and epithelial ingrowth [8].

Background

In children born with cleft (lip and) palateresonance and articulation disorders are often observed as aresult of structural deviations of the sound production mechanism.Even after palatal closure, compensatory articulationand resonance disturbance may persist, despite advances insurgical treatment of congenital orofacial clefts [1].

Material & Methods

This is a cross-sectional study thatwas conducted upon 70 patients with repaired cleft palate ofdifferent grades in Plastic Surgery Department Assiut UniversityHospital. Data was collected from May 2016 to December2018.

Results

The study enrolled 70 children with cleft palateand underwent palatoplasty; out of them 18 (25.7%) patientsdeveloped velopharyngeal dysfunction (VPI). 66% of patientwith velopharyngeal insufficiency has below average IQ.