Articles

Antibiotic-resistant bacteria are emerging pathogens whose resistance profiles generate a serious health crisis by holding their impact on human health. Misuse of antibiotics has directed the emergence of microbes immune to presently accessible drugs. Pathogenic bacteria become resistant by employing various mechanisms, such as; antibiotic modification, target site alteration, and biofilm formation, increasing the time they spend in the intracellular environment where antibiotics are unable to succeed at therapeutic levels. Due to this, attempts are being made to develop new alternative nanoantibiotics as a promising approach to treat multidrug resistance disease-causing bacteria. Accordingly, there is considerable contemporary attention to the use of nanoparticles (NPs) as antibacterial agents against different pathogens and as target drug delivery toward specific tissues therefore microbes are eliminated by the biocidal properties of nanoantibiotics. Additionally, the utilization of nanoencapsulation systems can help to beat the issues of, those with toxicity natures, and target drug delivery problems. This review encompasses the antibiotic resistance prevalence, mechanisms, and therefore the use of nanoparticles as antibacterial and drug delivery systems to overcome the antibiotic resistance challenges of bacteria. Overall, this review paper provides a conceptual framework for understanding the complexity of the matter of emergence of antibiotic resistance bacteria even for brand spanking new synthesized antibiotics. Therefore the availability of such knowledge will allow researchers to supply detailed studies about the applications of nanoparticles in the treatment of multidrug-resistant bacteria. 

A comprehensive approach to asymptomatic adults with Wolff-Parkinson-White (WPW) pattern discovered incidentally on routine electrocardiography (ECG) is debatable. The objective of this review article is to update the most recent evidence on the management of young patients with asymptomatic WPW patterns. A substantial proportion of adults with WPW patterns on ECG may remain asymptomatic but the lifetime risk for fatal arrhythmias still exists. The inherent properties of the accessory pathway determine the risk of sudden cardiac death. A low-risk pathway is considered when the pre-excitation is intermittent on ambulatory monitoring or when it disappears completely or abruptly during exercise testing. On the other hand, a high-risk pathway in EP study is suggested by the presence of the shortest pre-excited RR interval (SPERRI) during atrial fibrillation of ≤ 250 ms or accessory pathway effective refractory period (APERP) ≤ 240 ms. The cardiac evaluation may thus be considered in asymptomatic patients with WPW to determine the individual risk for future symptomatic arrhythmia. A shared-decision making must be performed before offering catheter ablation whose procedural success rate is high.

Background: Doubts about the safety of sexual activity are common among cardiac patients and physicians alike, and are often neglected during routine checkups or on discharge from the hospital following a cardiac event or invasive procedure. Although it varies from society to society, it is considered taboo by most patients, so it is reluctant to ask the doctor about sexual activity. Doctors, on the other hand, remain silent due to the lack of clear information about the effect of sexual activity on coronary artery diseases or the presence of doubts. It is ultimately set aside by professionals and their patients. The patient does not ask and the doctor does not answer. This study, it was aimed to investigate the effect of the frequency of sexual intercourse on coronary artery disease. Methods: After applying the exclusion criteria, the remaining 180 patients were included in the study. A self-administered survey was applied to the patients before coronary angiography and patients were assessed according to the presence of additional diseases, their demographic characteristics, and the frequency of sexual intercourse. Two experienced physicians evaluated the angiographic results. Firstly Patients were grouped as 90 patients with normal coronary anatomy and 90 patients with coronary artery disease. After this, Coronary artery disease severity was evaluated according to syntax score. Results: The mean age of the patients was 58 ± 12.5 years. The distribution of age is not reasonable. According to gender, the female/male ratio the proportion of men was higher in patients with coronary artery disease. İncidence of normal coronary anatomy increased as the frequency of sexual intercourse increased. P - value was 0.037 and the result was statistically significant. The frequency of sexual intercourse was found to be 4.2/per month. The relationship between the Syntax score and frequency of sexual intercourse was not statistically significant (p > 0.05).Conclusion: As a result of the study, it was seen that patients with more frequent sexual intercourse had more normal coronary artery anatomy, and those with coronary artery disease had single coronary artery disease than multiple vascular disorders. it was concluded that the incidence of coronary artery disease and coronary artery disease severity decreased as the frequency of sexual intercourse increased. Sexual intercourse might be a preventive factor in the development of coronary artery disease.

Cutaneous metastases of urothelial tumors are extremely rare. Iatrogenic tumor implantations are the main cause of this type of metastasis. We report the case of a 75-year-old patient who underwent nephroureterectomy with the removal of a bladder collarette for a tumor of the upper excretory tract; 3 years later the patient developed parietal swelling at the level of the lumbotomy scar. A histological study of the mass after surgical excision confirmed that it was a secondary location. Through a study of the literature, we will detail the clinical and paraclinical particularities of such a location as well as its impact on the prognosis.

Introduction: Primary central nervous system (PCNS) posttransplant lymphoproliferative disease (PTLD) is a rare complication of solid organ transplantation and treatment is not yet standardized.Case presentation: Here we report the case of a 54-year-old man who underwent renaltransplantation 22 years ago for end-stage renal disease. He had been on long-term immunosuppressive treatment consisting of orally administered prednisolone 10 mg and then 5 mg daily and orally administered Mycophenolate Mofetil 500 mg twice daily. He presented in January 2019 to emergency with aphasia and then partial seizure. On brain MRI there was an expansive cortical mass in the left temporal lobe with perilesional edema. Biopsy revealed a diffuse large B-cell lymphoma. He was treated with one cycle of Cytarabine with his usual immunosuppressive treatment. In view of his renal allograft, he was not suitable for Methotrexate due to the risk of toxicity. He died on day 15 caused by a sepsis choc secondary to febrile neutropenia.Conclusion: PCNS-PTLD is regarded as one of the most serious posttransplant complications due to its high mortality. Further clinical and experimental investigations are required to develop optimal diagnostic and treatment modalities.

This is a 19-year-old patient. His clinical examination finds an empty bursa with a palpable left testicle at the level of the inguinal canal.

In the 19th Century in much of Western Europe and North America the number and size of asylums increased hugely. In London, there was a wave of new asylums built in response to the 1808 County Asylums Act and the 1845 Lunacy Act, which required publicly funded care for those deemed mentally unwell. One such asylum was the Surrey County Lunatic Asylum which was built on the grounds which now house Springfield University Hospital in South West London.This paper describes the admission records from Surrey County Lunatic Asylum, between 1863-1867, from information stored in the London Metropolitan Archives. Although the terminology is different from that of today’s, the picture the records paint is of an institution aiming at recovery rather than long-term incarceration which can be how asylums are now remembered. This more nuanced view is starting to be discussed more in public conversations about the topic. The optimism this may imbue is tempered by the shocking number of patients who died within the institution.

A Fregoli syndrome, just like Capgras Syndrome, Double Subjective Syndrome, and Inter metamorphosis Syndrome, belongs to the group of delusion misidentification syndromes. It is a rare neuropsychiatric pathology that could affect the brain with repercussions on behavior. It is the belief that a familiar person is disguised as a strange person by taking a different physical appearance but remains the same person psychologically. This entity has heterogonous etiologies, occurring mainly in the setting of organic diseases, affective disorders, or schizophrenia. In this article, we proposed to expose a case of a schizophrenic patient who developed Fregoli syndrome.

Introduction: Studies have shown a high prevalence of sexual dysfunction in Medical residents. Psychological, interpersonal, and sociocultural factors play an important role in sexual vulnerability. In addition, distraction or interference in the cognitive process of the erotic stimulus plays an important role in the development of sexual dysfunction. The aim of our study was to determine the prevalence of sexual dysfunctions among a sample of married female medical resident doctors and to explore its relation with cognitive distraction during sex.Subjects and methods: This was a cross-sectional study, which was carried out in October 2017 with 70 married female medical resident doctors. We used the Female Sexual Function Index (FSFI) for sexual functioning assessment and the cognitive distraction during sex scale. Results: The mean age of women was 30.52 years. They had been married for 6.04 years on the mean. The majority (74%) had children. According to the FSFI, 40% of resident doctors had sexual dysfunction. The mean cognitive distraction during sex score was 4.37.In our study, women with female sexual dysfunction reported significantly lower sexual desire score = 3.2 vs. 4.1 and p = 0.03) and arousal (score = 3.è vs. 4.7 and p = 10-3), decreased lubrication (score = 3.8 vs. 5.1; p = 10-3), less sexual satisfaction (score = 3.9 vs. 5.8; p = 10-3)and higher orgasm difficulties (score = 3.4 vs. 5.1; p = 10-3). Yet, our results highlighted that women with female sexual dysfunction presented significantly more cognitive distraction during sex (score = 3.9 vs. 4.6; p = 0.03). Conclusion: According to our study, it appears that the prevalence of FSD in medical resident doctors is considerable. Besides, intrusive thoughts and cognitive distraction during sexual intercourse are importantly associated with sexual functioning. Therefore, several measures should be implemented in this population to prevent or act on these factors.

Sclerotinia sclerotiorum (Lib.) de Bary caused white mold disease with a wide distribution worldwide. For the control of the disease, it is fundamental to understand the identification, morphology, and genetic diversity of the fungus. The objective of this study was to collect and characterize S. sclerotiorum isolates from different regions of the country. The characteristics evaluated for the mycelium characterization were: the time required for the fungus to occupy the plate; density of the formed mycelium; coloration of the colonies and mycelia growth rate. Sclerotia assessments were based on the time for the formation of the first sclerotia total number formed per plate, the format of distribution in the plate, and the shape of the sclerotia formed by the isolates. Variability was observed for colony colour, type of growth, the diameter of mycelia growth, sclerotia initiation, and number and pattern of sclerotia formation among the isolates. The evaluated populations presented wide variability for the cultural and morphological characteristics, being predominant in the whitish colonies with fast-growing habitats. The majority of isolates produced a higher number of sclerotia near the margin of the plates and with diverse formats. Phylogenetic analysis revealed that the isolates belonged to a similar group of publicly available S. sclerotiorum and were dissimilar from the group of S. minor, and S. trifolium and distinctly differ from S. nivalis group. The present study is the first evidence for morphological and genetic diversity study of S. sclerotiorum in Bangladesh. Therefore, this report contributes to more information about the morphological and genetic diversity of S. sclerotiorum and can be useful in implementing effective management strategies for the pathogen which caused white mold disease.