Search results for: Adel Azar

Authors: Ayman El Sabagh, SobhySorour, AbdElhamid Omar, Adel Ragab, Mohammad Sohidul Islam, Celaleddin Barutçular, Akihiro Ueda, Hirofumi Saneoka

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Salinity is one of the major factors limiting crop production in an arid environment. What adds to the concern is that all the legume crops are sensitive to increasing soil salinity. So it is implacable to either search for salinity enhancement of legume plants. The exogenous of osmoprotectants has been found effective in reducing the adverse effects of salinity stress on plant growth. Despite its global importance soybean production suffer the problems of salinity stress causing damages at plant development. Therefore, in the current study we try to clarify the mechanism that might be involved in the ameliorating effects of osmo-protectants such as proline and glycine betaine and compost application on soybean plants grown under salinity stress. Experiments were carried out in the greenhouse of the experimental station, plant nutritional physiology, Hiroshima University, Japan in 2011- 2012. The experiment was arranged in a factorial design with 4 replications at NaCl concentrations (0 and 15 mM). The exogenous, proline and glycine betaine concentrations (0 mM and 25 mM) for each. Compost treatments (0 and 24 t ha-1). Results indicated that salinity stress induced reduction in all growth and physiological parameters (dry weights plant-1, chlorophyll content, N and K+ content) likewise, seed and quality traits of soybean plant compared with those of the unstressed plants. In contrast, salinity stress led to increases in the electrolyte leakage ratio, Na and proline contents. Thus tolerance against salt stress was observed, the improvement of salt tolerance resulted from proline, glycine betaine and compost were accompanied with improved membrane stability, K+, and proline accumulation on contrary, decreased Na+ content. These results clearly demonstrate that could be used to reduce the harmful effect of salinity on both physiological aspects and growth parameters of soybean. They are capable of restoring yield potential and quality of seed and may be useful in agronomic situations where saline conditions are diagnosed as a problem. Consequently, exogenous osmo-protectants combine with compost will effectively solve seasonal salinity stress problem and are a good strategy to increase salinity resistance in the drylands.

Keywords: compost, glycine betaine, proline, salinity tolerance, soybean

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Authors: Abdelkader Guendouz, Fatima Zohra Adel

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Even if both the economic and the human development are an axial pillar in its global policy, Algerian government seems to be more and more engaged in the international context aiming to reach of the so called millennium development goals, and this since its beginning. By looking closely at the Algerian economic policy, it is easy to mention the existence of several programs in which both economic and social realisations including among others, poverty reduction, enhancement of education level and conditions, woman statute and gender equity amelioration targets. The efforts of Algerian government in the field of these targets had been acheminated through three main plans, which are: -PSRE (Plan de Soutien à la Relance Economique), for the period of 2001 to 2004, initiated with about 7 billion US dollar, had been focused on three objectives, namely, poverty reduction, job creation and regional equilibrium with rural areas revitalization. -PCSC (le Programme complémentaire de soutien à la croissance économique), for the period of 2005 to 2009, with a starting funding of 114 billion US dollar. This program aims to develop public services and supporting public investments, especially in which concerns social infrastructures. Now, and at the end of the maturity of the MDGs agenda, an important question is to be asked: what are the main realizations regarding these MDGs? In order to answer this question, the present paper tries to examine the Algerian economic policy (but also the social one) by considering the MDGs challenges, for the period from 2000 to 2010, but also until 2015. This examination is focused on three main targets, namely poverty, education, and health. Firstly, statistical assessment for the Algerian economic and social situation shows that almost all MDGs had been reached during the period of 2000 to 2009 and it continues to maintain and improve them. This observation can be endorsed by invoking some achievements. Starting by the reduction of poverty, the proportion of population living with less than 1 US dollar per a day passed from 8.0 % in 2000 to 0.5 % in 2009, and 0.3 % in 2015. For education sphere, the enrolment ratio of six-year child, which is the most significant index for school attendance, is about 98 % for 2009 against 93 % in 1999, and only 43 % in 1966. Concluding with health care and relevant services; the Algerian government has accomplished big steps in providing easy access to this sector for the population. Moreover, the percentage of assisted accouchement had been raised from 91.2 % in 2000 to 97.2 % in 2009.

Keywords: Algerian economic policy, MDGs, poverty, education, health

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Authors: Adel S. Alanazi

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The transition of a student with a disability from school to work is the most crucial phase while moving from the stage of adolescence into early adulthood. In this process, young individuals face various difficulties and challenges in order to accomplish the next venture of life successfully. In this respect, this paper aims to examine the challenges encountered by the individuals with intellectual disabilities in transition to work in Saudi Arabia. For this purpose, this study has undertaken a qualitative research-based methodology; wherein interpretivist philosophy has been followed along with inductive approach and exploratory research design. The data for the research has been gathered with the help of semi-structured interviews, whose findings are analysed with the help of thematic analysis. Semi-structured interviews were conducted with parents of persons with intellectual disabilities, officials, supervisors and specialists of two vocational rehabilitation centres providing training to intellectually disabled students, in addition to that, directors of companies and websites in hiring those individuals. The total number of respondents for the interview was 15. The purposive sampling method was used to select the respondents for the interview. This sampling method is a non-probability sampling method which draws respondents from a known population and allows flexibility and suitability in selecting the participants for the study. The findings gathered from the interview revealed that the lack of awareness among their parents regarding the rights of their children who are intellectually disabled; the lack of adequate communication and coordination between various entities; concerns regarding their training and subsequent employment are the key difficulties experienced by the individuals with intellectual disabilities. Training in programmes such as bookbinding, carpentry, computing, agriculture, electricity and telephone exchange operations were involved as key training programmes. The findings of this study also revealed that information technology and media were playing a significant role in smoothing the transition to employment of individuals with intellectual disabilities. Furthermore, religious and cultural attitudes have been identified to be restricted for people with such disabilities in seeking advantages from job opportunities. On the basis of these findings, it can be implied that the information gathered through this study will serve to be highly beneficial for Saudi Arabian schools/ rehabilitation centres for individuals with intellectual disability to facilitate them in overcoming the problems they encounter during the transition to work.

Keywords: intellectual disability, transition services, rehabilitation centre, employment

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Authors: Nermeen Saad Elbeltagy, Hoda Ghareeb, Hesham Adel Elsheshtawy, Nadim Hamed, Amany Ibrahim Mostafa, Sara Hazem Hassan

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Introduction: Depression is one of the most common mental health problems occurring in women during their child bearing years. Perinatal depression refers to major and minor depressive episodes that occur either during pregnancy or aer delivery. Although perinatal depression is common in developing countries, it is under-recognized in low and middle income countries making a substantial contribution to maternal and infant morbidity and mortality. About 12.5 - 42% of pregnant women and, 12 - 50% of post natal mothers in low and middle income countries such as Ethiopia had depression AIM OF THE WORK: To study prevalence, associated factors and impact of maternal perinatal depression in Alexandria. Patients and method: This study was conducted on 300 mothers at the postnatal ward in ElShatby Maternity Hospital from April 2022 unl October 2022. Females with past history of depression before pregnancy or females who receive medications inducing depression were excluded. The participants were asked to complete the questionnaire that includes the Edinburgh Postnatal Depression Scale (EPDS) as a screening test to obtain information concerning the current frame of mind at antepartum, partum and postpartum periods Results: The prevalence of perinatal depression was 22.3%. It was found that there is a significant negave moderate correlation between socioeconomic status and perinatal depression(r=-0.42). The present study revealed that about two thirds (60.7%) of postpartum women had low socioeconomic level. Also, less than one fourth (20%) of parents had high education and only one fourth (25.3%) of postpartum women were working. There was a statically significance difference between the number of previous abortions and perinatal depression (p=0.04). There was a significant moderate correlation between the amount of blood lost during delivery and an increased risk of developing postpartum depression. The prevalence of perinatal depression was high in cases of female neonates more than male ones. Conclusion: the prevalence of perinatal depression among the studied women was 22.3% of studied group. The significant factors identified in this study can be targeted to reduce the occurrence of perinatal depression among pregnant women in Alexandria through appropriate health interventions which includes perinatal depression screening, counseling, and the provision of support for pregnant women during antenatal care as well as lifestyle modification.

Keywords: mental health, depression in pregnancy, mental disorders, psychology in pregnancy

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Authors: Adel Edwar Waheeb Louka

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Purpose AI-driven solutions are at the forefront of many pathology and medical imaging methods. Using algorithms designed to better the experience of medical professionals within their respective fields, the efficiency and accuracy of diagnosis can improve. In particular, X-rays are a fast and relatively inexpensive test that can diagnose diseases. In recent years, X-rays have not been widely used to detect and diagnose COVID-19. The under use of Xrays is mainly due to the low diagnostic accuracy and confounding with pneumonia, another respiratory disease. However, research in this field has expressed a possibility that artificial neural networks can successfully diagnose COVID-19 with high accuracy. Models and Data The dataset used is the COVID-19 Radiography Database. This dataset includes images and masks of chest X-rays under the labels of COVID-19, normal, and pneumonia. The classification model developed uses an autoencoder and a pre-trained convolutional neural network (DenseNet201) to provide transfer learning to the model. The model then uses a deep neural network to finalize the feature extraction and predict the diagnosis for the input image. This model was trained on 4035 images and validated on 807 separate images from the ones used for training. The images used to train the classification model include an important feature: the pictures are cropped beforehand to eliminate distractions when training the model. The image segmentation model uses an improved U-Net architecture. This model is used to extract the lung mask from the chest X-ray image. The model is trained on 8577 images and validated on a validation split of 20%. These models are calculated using the external dataset for validation. The models’ accuracy, precision, recall, f1-score, IOU, and loss are calculated. Results The classification model achieved an accuracy of 97.65% and a loss of 0.1234 when differentiating COVID19-infected, pneumonia-infected, and normal lung X-rays. The segmentation model achieved an accuracy of 97.31% and an IOU of 0.928. Conclusion The models proposed can detect COVID-19, pneumonia, and normal lungs with high accuracy and derive the lung mask from a chest X-ray with similarly high accuracy. The hope is for these models to elevate the experience of medical professionals and provide insight into the future of the methods used.

Keywords: artificial intelligence, convolutional neural networks, deeplearning, image processing, machine learningSarapin, intraarticular, chronic knee pain, osteoarthritisFNS, trauma, hip, neck femur fracture, minimally invasive surgery

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Authors: Adel Pasztor

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International doctoral mobility is a largely under-researched component of academic mobility and migration. This is in stark contrast to the case of student mobility where much research has been undertaken on Erasmus students; or the growing research on academic staff mobility which can be viewed as a key part of highly skilled migration. The aim of this paper is to remedy the situation by specifically focusing on international doctoral students studying at elite higher education institutions in the United Kingdom. In doing so, in-depth qualitative interviews with doctoral students and recent graduates were carried out in order to identify the signifiers of an internationally mobile doctoral student and unpack the decision-making processes leading onto the choice of higher education institution abroad. Overall, a diverse range of degree subjects from within the humanities and the social sciences were covered with a relatively large spread of nationalities which include the following countries: Italy, Germany, Hungary, Latvia, Bulgaria, Turkey, Lebanon, Israel, Australia, USA, China, and Chile. The interview questions were designed to probe the motivations, choices, educational trajectories and career plans of international doctoral students relative to their social class background, gender, nationality or funding. It was clear from the interviews that there were two main types of international doctoral students: those who ‘did not think anything else was ever a serious possibility’, contrasted with the other, more opportune type, to whom ‘it happened to be a PhD’. There were marked differences between the two types since initial access to university, mainly because educational decisions such as the doctorate do not happen in a vacuum, rather are built on the individual’s higher education aspirations and previous educational choices. The results were in line with existing literature suggesting that those with higher educated parents and from schools strongly supporting the choice process fared better as they were able to make well informed, well thought through as well as strategic decisions for their future involving the very best universities within the national boundaries. Being ‘at the right place’ often meant access to prestigious doctoral scholarships thus, the route of the PhD has been chosen even if it did not necessarily enhance career opportunities. At the same time, the initial higher education choices of those with limited capital were played out locally, although they did aim for the best universities within their geographically constrained landscape of choice. Here, the majority of students referred to some ‘turning points’ in their lives which lead them towards considering international doctoral opportunities but essentially their proactive, do-it-yourself attitude was behind the life-changing educational opportunities.

Keywords: choice, doctoral students, international mobility, PhD, UK

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Authors: Mujahid Muhammad, Paul Kearney, Adel Aneiba

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The ability for vehicles to communicate with other vehicles (V2V), the physical (V2I) and network (V2N) infrastructures, pedestrians (V2P), etc. – collectively known as V2X (Vehicle to Everything) – will enable a broad and growing set of applications and services within the intelligent transport domain for improving road safety, alleviate traffic congestion and support autonomous driving. The telecommunication research and industry communities and standardization bodies (notably 3GPP) has finally approved in Release 14, cellular communications connectivity to support V2X communication (known as LTE – V2X). LTE – V2X system will combine simultaneous connectivity across existing LTE network infrastructures via LTE-Uu interface and direct device-to-device (D2D) communications. In order for V2X services to function effectively, a robust security mechanism is needed to ensure legal and safe interaction among authenticated V2X entities in the LTE-based V2X architecture. The characteristics of vehicular networks, and the nature of most V2X applications, which involve human safety makes it significant to protect V2X messages from attacks that can result in catastrophically wrong decisions/actions include ones affecting road safety. Attack vectors include impersonation attacks, modification, masquerading, replay, MiM attacks, and Sybil attacks. In this paper, we focus our attention on LTE-based V2X security and access control mechanisms. The current LTE-A security framework provides its own access authentication scheme, the AKA protocol for mutual authentication and other essential cryptographic operations between UEs and the network. V2N systems can leverage this protocol to achieve mutual authentication between vehicles and the mobile core network. However, this protocol experiences technical challenges, such as high signaling overhead, lack of synchronization, handover delay and potential control plane signaling overloads, as well as privacy preservation issues, which cannot satisfy the adequate security requirements for majority of LTE-based V2X services. This paper examines these challenges and points to possible ways by which they can be addressed. One possible solution, is the implementation of the distributed peer-to-peer LTE security mechanism based on the Bitcoin/Namecoin framework, to allow for security operations with minimal overhead cost, which is desirable for V2X services. The proposed architecture can ensure fast, secure and robust V2X services under LTE network while meeting V2X security requirements.

Keywords: authentication, long term evolution, security, vehicle-to-everything

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Authors: Judit Perjessy, Zsolt Zalan, Ferenc Hegyi, Eniko Horvath-Szanics, Krisztina Takacs, Andras Nagy, Adel Klupacs, Erika Koppany-Szabo, Zhirong Wang, Kaituo Wang, Muying Du, Jianquan Kan

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The post-harvest diseases cause great economic losses in the fruit and vegetables; the prevention of these deterioration has great importance. Against the fungi, which cause most of the diseases, are extensively used the fungicides. However, there are increasing consumer concerns over the presence of pesticide residues in food. An alternative and in recent years, increasingly studied method for the prevention of the diseases is biocontrol, where antagonistic microorganisms are used for the control of fungi. The genera of Lactobacillus is well known and extensively studied, but its applicability as biocontrol agents in post-harvest preservation of fruit and vegetables is poorly investigated. However these bacteria can be found on the surface of the plants and have great antimicrobial activity. In our study we have investigated the chitinase activity, the antifungal effect and the applicability of several Lactobacillus strains to select potential biocontrol agents. We investigated the determination of the environmental parameters of a gene (encoding chitinase) expression and we also investigated the relationship between actual antifungal activity and potential chitinase activity. Mixed cultures were also developed to enhance the antifungal activity and determined the optimal mold spore and bacteria concentration ratio for the appropriate efficacy. Five Lactobacillus strains (L. acidophilus N2, L. delbrueckii subsp. bulgaricus B397, L. sp. 2231, L. sake subsp. sake 2471, L. buchneri 1145) possess chitinase-coding gene from the 43 investigated Lactobacillus strains. Proteins with similar molecular weight and separation properties like bacterial chitinases were detected from these strains, which also possess chitin-binding property. Nevertheless, they were inactive, lacks the chitinolytic activity. In point of the cumulative activity of inhibition, our results showed that certain strains were statistically significant in a positive direction compared to other strains, e.g., L. rhamnosus VT1 and L. Casey 154 have shown great general antifungal effect against 11 molds from the genera Penicillium and Botrytis and isolated from spoiled fruit and vegetables. Also, some mixed cultures (L. rhamnosus VT1 - L. Plantarum 299v) showed significant antifungal effects against the indigenous molds on the surface of apple fruit during the industrial storage experiment. Thus, they could be promising for post-harvest biopreservation.

Keywords: biocontrol, chitinase, Lactobacillus, post-harvest

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Authors: Adel A. Ghoneim

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In most existing buildings in hot climate, cooling loads lead to high primary energy consumption and consequently high CO2 emissions. These can be substantially decreased with integrated renewable energy systems. Kuwait is characterized by its dry hot long summer and short warm winter. Kuwait receives annual total radiation more than 5280 MJ/m2 with approximately 3347 h of sunshine. Solar energy systems consist of PV modules and parabolic trough collectors are considered to satisfy electricity consumption, domestic water heating, and cooling loads of an existing building. This paper presents the results of an extensive program of energy conservation and energy generation using integrated photovoltaic (PV) modules and parabolic trough collectors (PTC). The program conducted on an existing institutional building intending to convert it into a Net-Zero Energy Building (NZEB) or near net Zero Energy Building (nNZEB). The program consists of two phases; the first phase is concerned with energy auditing and energy conservation measures at minimum cost and the second phase considers the installation of photovoltaic modules and parabolic trough collectors. The 2-storey building under consideration is the Applied Sciences Department at the College of Technological Studies, Kuwait. Single effect lithium bromide water absorption chillers are implemented to provide air conditioning load to the building. A numerical model is developed to evaluate the performance of parabolic trough collectors in Kuwait climate. Transient simulation program (TRNSYS) is adapted to simulate the performance of different solar system components. In addition, a numerical model is developed to assess the environmental impacts of building integrated renewable energy systems. Results indicate that efficient energy conservation can play an important role in converting the existing buildings into NZEBs as it saves a significant portion of annual energy consumption of the building. The first phase results in an energy conservation of about 28% of the building consumption. In the second phase, the integrated PV completely covers the lighting and equipment loads of the building. On the other hand, parabolic trough collectors of optimum area of 765 m2 can satisfy a significant portion of the cooling load, i.e about73% of the total building cooling load. The annual avoided CO2 emission is evaluated at the optimum conditions to assess the environmental impacts of renewable energy systems. The total annual avoided CO2 emission is about 680 metric ton/year which confirms the environmental impacts of these systems in Kuwait.

Keywords: building integrated renewable systems, Net-Zero energy building, solar fraction, avoided CO2 emission

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Authors: Mohamed Adel Ahmed, Warda Youssef Morsy , Hanaa Ali El Feky

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Background: Literature review cited that sleep is absolutely essential for surviving and reclamation of the quality of life. Critically ill patients often have poor sleep quality with prolonged sleep latency, sleep fragmentation, decreased sleep efficiency and frequent arousals. Nurses have a unique role for the early diagnosis of sleep disorders, decreasing stressors levels and providing the necessary environmental regulations to create a therapeutic ambiance. The aim of the study: to assess perceived sleep quality and identify factors affecting sleep quality among adult critically ill patients At El Manial University Hospital. Research Design: A descriptive exploratory design was utilized. Research questions: a) how do adult critically ill patients perceive sleep quality in the Critical Care Department of El Manial University Hospital? b) What are the factors affecting sleep quality among adult critically ill patients at El Manial University Hospital? Setting: selected critical and cardiac care units at El Manial University Hospital. Sample: A samples of convenience consisting of 100 adult male and female patients were included in the study. Tools of data collection: tool 1: Socio-demographic and Medical Data Sheet, tool 2: Modified St Mary's Hospital Sleep Questionnaire tool 3: Factors Affecting Sleep Quality Questionnaire among ICU Patients Results: The current study revealed that 76.0% of the studied sample had lack of sleep disturbance before hospitalization. However, 84 % had sleep disturbances during ICU stay, of these more than two-thirds (67 %) had moderate sleep disturbance. Presence of strange and bad odors, noise, having pain, fear of death and a loud voice produced by the ICU personnel had the most significant negative impact on patients’ sleep in percentage of 52.4, 50, 61.9, 45.2, 52.4, respectively. Conclusion: Sleep disturbances in the ICU are multifactorial, and ICU patients’ perceived degrees of sleep disturbance as a moderate. Recommendations: Based on findings of the present study, the following are recommended to be done by ICU nurses; create a healing ICU environment that should incorporate noise, light and temperature controls; decrease stimuli during night time hours to promote regulation of the circadian rhythm, allow usage of sleeping aids such as relaxing music, eye patches and earplugs into their daily nursing practice; cluster nursing activities and eliminate non-essential treatments during night time hours to allow uninterrupted sleep periods of at least 90 minutes to complete one sleep cycle , and minimize staff conversation, alarm noise and light during the quiet night time hours.

Keywords: sleep quality, critically ill, patients, perception

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Authors: Shayma Mohammed, Adel Trabelsi

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Radiopharmacy is the art of preparing high-quality, radioactive, medicinal products for use in diagnosis and therapy. Radiopharmaceuticals unlike normal medicines, this dual aspect (radioactive, medical) makes their management highly critical. One of the most convincing applications of modern technologies is the ability to delegate the execution of repetitive tasks to programming scripts. Automation has found its way to the most skilled jobs, to improve the company's overall performance by allowing human workers to focus on more important tasks than document filling. This project aims to contribute to implement a comprehensive system to insure rigorous management of radiopharmaceuticals through the use of a platform that links the Nuclear Medicine Service Management System to the Nuclear Radio-pharmacy Management System in accordance with the recommendations of World Health Organization (WHO) and International Atomic Energy Agency (IAEA). In this project we attempt to build a web application that targets radiopharmacies, the platform is built atop the inherently compatible web stack which allows it to work in virtually any environment. Different technologies are used in this project (PHP, Symfony, MySQL Workbench, Bootstrap, Angular 7, Visual Studio Code and TypeScript). The operating principle of the platform is mainly based on two parts: Radiopharmaceutical Backoffice for the Radiopharmacian, who is responsible for the realization of radiopharmaceutical preparations and their delivery and Medical Backoffice for the Doctor, who holds the authorization for the possession and use of radionuclides and he/she is responsible for ordering radioactive products. The application consists of sven modules: Production, Quality Control/Quality Assurance, Release, General Management, References, Transport and Stock Management. It allows 8 classes of users: The Production Manager (PM), Quality Control Manager (QCM), Stock Manager (SM), General Manager (GM), Client (Doctor), Parking and Transport Manager (PTM), Qualified Person (QP) and Technical and Production Staff. Digital platform bringing together all players involved in the use of radiopharmaceuticals and integrating the stages of preparation, production and distribution, Web technologies, in particular, promise to offer all the benefits of automation while requiring no more than a web browser to act as a user client, which is a strength because the web stack is by nature multi-platform. This platform will provide a traceability system for radiopharmaceuticals products to ensure the safety and radioprotection of actors and of patients. The new integrated platform is an alternative to write all the boilerplate paperwork manually, which is a tedious and error-prone task. It would minimize manual human manipulation, which has proven to be the main source of error in nuclear medicine. A codified electronic transfer of information from radiopharmaceutical preparation to delivery will further reduce the risk of maladministration.

Keywords: automated system, management, radiopharmacy, technical papers

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Authors: Nourhan Hussein Fanaki, Hoda Mohamed Gamal El-Din Omar, Nihal Kadry Moussa, Eva Adel Edward Farid

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The resistance of staphylococci to various antibiotics has become a major concern for health care professionals. The efficacy of the combinations of selected glycopeptides (vancomycin and teicoplanin) with gentamicin or rifampicin, as well as that of gentamicin/rifampicin combination, was studied against selected pathogenic staphylococcus isolated from Egypt. The molecular distribution of genes conferring resistance to these four antibiotics was detected among tested clinical isolates. Antibiotic combinations were studied using the checkerboard technique and the time-kill assay (in both the stationary and log phases). Induction of resistance to glycopeptides in staphylococci was tried in the absence and presence of diclofenac sodium as inducer. Transmission electron microscopy was used to study the effect of glycopeptides on the ultrastructure of the cell wall of staphylococci. Attempts were made to cure gentamicin resistance plasmids and to study the transfer of these plasmids by conjugation. Trials for the transformation of the successfully isolated gentamicin resistance plasmid to competent cells were carried out. The detection of genes conferring resistance to the tested antibiotics was performed using the polymerase chain reaction. The studied antibiotic combinations proved their efficacy, especially when tested during the log phase. Induction of resistance to glycopeptides in staphylococci was more promising in presence of diclofenac sodium, compared to its absence. Transmission electron microscopy revealed the thickening of bacterial cell wall in staphylococcus clinical isolates due to the presence of tested glycopeptides. Curing of gentamicin resistance plasmids was only successful in 2 out of 9 tested isolates, with a curing rate of 1 percent for each. Both isolates, when used as donors in conjugation experiments, yielded promising conjugation frequencies ranging between 5.4 X 10-2 and 7.48 X 10-2 colony forming unit/donor cells. Plasmid isolation was only successful in one out of the two tested isolates. However, low transformation efficiency (59.7 transformants/microgram plasmid DNA) of such plasmids was obtained. Negative regulators of autolysis, such as arlR, lytR and lrgB, as well as cell-wall associated genes, such as pbp4 and/or pbp2, were detected in staphylococcus isolates with reduced susceptibility to the tested glycopeptides. Concerning rifampicin resistance genes, rpoBstaph was detected in 75 percent of the tested staphylococcus isolates. It could be concluded that in vitro studies emphasized the usefulness of the combination of vancomycin or teicoplanin with gentamicin or rifampicin, as well as that of gentamicin with rifampicin, against staphylococci showing varying resistance patterns. However, further in vivo studies are required to ensure the safety and efficacy of such combinations. Diclofenac sodium can act as an inducer of resistance to glycopeptides in staphylococci. Cell-wall thickness is a major contributor to such resistance among them. Gentamicin resistance in these strains could be chromosomally or plasmid mediated. Multiple mutations in the rpoB gene could mediate staphylococcus resistance to rifampicin.

Keywords: glycopeptides, combinations, induction, diclofenac, transmission electron microscopy, polymerase chain reaction

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