Enhancing physical characteristics and antibacterial efficacy of chitosan through investigation of microwave-assisted chemically formulated chitosan-coated ZnO and chitosan/ZnO physical composite

This study investigates the creation and analysis of chitosan-zinc oxide (CS-ZnO) nanocomposites, exploring their effectiveness in inhibiting bacteria. Two synthesis approaches, physical and chemical, were utilized. The CS-ZnO nanocomposites demonstrated strong antibacterial properties, especially against Staphylococcus aureus, a Gram-positive bacterium. Chemically synthesized nanocomposites (CZ10 and CZ100) exhibited larger inhibition zones (16.4 mm and 18.7 mm) compared to physically prepared CS-Z5 and CS-Z20 (12.2 mm and 13.8 mm) against Staphylococcus aureus. Moreover, CZ nanocomposites displayed enhanced thermal stability, with decomposition temperatures of 281°C and 290°C, surpassing CS-Z5 and CS-Z20 (260°C and 258°C). The residual mass percentages at 800°C were significantly higher for CZ10 and CZ100 (58% and 61%) than for CS-Z5 and CS-Z20 (36% and 34%). UV-Visible spectroscopy revealed reduced band gaps in the CS-ZnO nanocomposites, indicating improved light absorption. Transmission electron microscopy (TEM) confirmed uniform dispersion of ZnO nanoparticles within the chitosan matrix. In conclusion, this research underscores the impressive antimicrobial potential of CS-ZnO nanocomposites, especially against Gram-positive bacteria, and highlights their enhanced thermal stability. These findings hold promise for diverse applications in industries such as medicine, pharmaceuticals, and materials science, contributing to the development of sustainable materials with robust antimicrobial properties.

Burden and Outcome of Vitamin D Deficiency Among Critically Ill Patients: A Prospective Study

BACKGROUND

Vitamin D deficiency is a prevalent condition among critically ill patients. Information about the relationship between vitamin D levels and outcomes in the intensive care unit (ICU) is sparse.

PURPOSE

To evaluate vitamin D status among critically ill patients and its relevance to severity of illness, ICU stay period, and mortality.

METHODS

This prospective multicenter study was conducted in the ICUs of Fayoum, Cairo, Alazhar, and Ain Shams university hospitals. All patients were subjected to interview questionnaire, laboratory investigation, vitamin D level assessment, and severity of illness evaluation using the Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II) score.

RESULTS

In total, 250 patients were included in the study. The median age was 62 (40-73) years, and most patients were male (52%). The median serum level of vitamin D was 19 (7-40.6). Vitamin D was deficient in 197 patients (78.8%) on admission. While we grouped the ICU patients as vitamin D deficient, insufficient, and sufficient, vitamin D-deficient patients had more severe diseases (mean APACHE II score, 44 ± 15; P = .014). Prolonged ICU stay was observed among the deficient group but with no significant association. The overall mortality rate was 6.8%; of these, 70.5% were vitamin D-deficient patients. However, logistic regression analysis demonstrated that vitamin D deficiency was not an independent risk factor for mortality.

CONCLUSION

Vitamin D insufficiency is common in critically ill patients (69%); it is associated with more severity of illness, but it is not an independent risk factor for longer ICU stay or mortality.

CLINICAL SIGNIFICANCE OF SERUM N-TERMINAL PRO C-TYPE NATRIURETIC PEPTIDE IN HEPATITIS C-RELATED CHRONIC LIVER DISEASES

To evaluate the clinical utility of serum levels of N-terminal pro C-type natruretic pep-tide (NT-pro CNP) in patients with hepatitis C related chronic liver disease (CLD), in prospective to disease complications and progression. This study included 66 hepatitis C-related CLD patients with and without ascites and 15 healthy individuals (control group). Serum NT-pro CNP was measured by ELISA. A stepwise progressive increase in NT-pro CNP levels was recorded through controls, patients without ascites and patients with ascites (p< 0.05). In addition, patients with hematemesis or encephalopathy had more than its double values than those without (p<0.01). Moreover, a significant difference was observed in the marker levels among esophageal varcies stages 1, 2, 3 (H=13.679, p=0.001), with highest levels in grade 3. NT-pro CNP correlated positively with alpha fetoprotein (rs =0.455, p=0.008) with no significant correlation neither with MELD nor Child scores (p>0.05). ROC curve analysis revealed the overall performance of the marker in discriminating CLD patients collectively from controls, the optimum cut-off level was 85 ng/L (AUC= 0. 803, sensitivity 84.8%& specificity 53.3%). An increased level of NT-pro CNP is a promising non-invasive marker of hepatitis C related CLD complications and disease progression.

Effect of vitamin D therapy on interleukin-6, visfatin, and hyaluronic acid levels in chronic hepatitis C Egyptian patients

Objectives

We aimed to compare serum levels of interleukin-6, visfatin, and hyaluronic acid in chronic hepatitis C Egyptian patients who received standard of care (SOC) therapy for chronic hepatitis C virus (HCV) consisting of pegylated interferon (PEG-IFN) and ribavirin (RBV) and in those who received SOC with vitamin D (vit D) for 48 weeks in HCV genotype 4a subjects.

Design and methods

One hundred chronic HCV patients were classified into two groups: study 50 patients received SOC therapy PEG-IFN/RBV + vit D and control 50 patients received SOC PEG-IFN/RBV without vit D. Both groups were followed up at 12 weeks, 24 weeks, and 48 weeks of treatment.

Results

Results showed a significant elevation in vit D levels in the group treated with SOC and vit D compared to SOC group and a reduction in HCV RNA from the 12th week to reach zero level in the 24th week. Interleukin-6, visfatin, and hyaluronic acid levels were also reduced significantly. Alanine transaminase and aspartate transaminase biomarkers were significantly reduced, indicating decreased liver injury.

Conclusion

SOC PEG-IFN/RBV + vit D therapy for chronic HCV led to reduced interleukin-6, visfatin, and hyaluronic acid levels and follow up liver biochemical biomarkers as aspartate transaminase and alanine transaminase indicates proper liver healing and monitoring.

Laryngeal involvement in juvenile idiopathic arthritis patients

Juvenile idiopathic arthritis (JIA) is an autoimmune diseases characterized by chronic arthritis and systemic manifestations. Autoimmune diseases can affect the upper airways including the larynx. The aim of this study was to investigate laryngeal involvement in JIA patients and its possible association with JIA disease parameters. Fifty consecutive JIA patients were screened for laryngeal abnormalities using flexible fiberoptic laryngoscope and laryngeal computerized tomography. Laryngeal abnormalities were detected in nine (18%) of our cases, with cricoarytenoiditis in six cases (12%) and a rheumatoid nodule in the pyriform fossa in only one case (2%). Diffuse congestion and edema of the posterior part of the larynx with normal vocal cord mobility was detected in two cases (4%). In our study, laryngeal abnormalities were significantly higher in patients with polyarticular seropositive disease subtype and also were significantly higher in patients with longer disease duration, higher disease activity scores, and those with erosive disease. JIA may affect the larynx. Laryngeal involvement in JIA patients is more in polyarticular seropositive cases. JIA patients have to be subjected to thorough otolaryngologic examination for early diagnosis and prompt management.