Search results for: Nourhan M. Abd El-Aziz

Authors: Karim Matter, Heba Fayed, Ahmed Abd-Elaziz, Moustafa Hussein

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Due to the exponential growth of mobile devices and wireless services, a huge demand for radiofrequency has increased. The presence of several frequencies causes interference between cells, which must be minimized to get the lower Bit Error Rate (BER). For this reason, it is of great interest to use visible light communication (VLC). This paper suggests a VLC system that decreases the BER by applying a new LED distribution with a hexagonal shape using a Frequency Reuse (FR) concept to mitigate the interference between the reused frequencies inside the hexagonal shape. The BER is measured in two scenarios, Line of Sight (LoS) and Non-Line of Sight (Non-LoS), for each technique that we used. The recommended values of BER in the proposed model for Soft Frequency Reuse (SFR) in the case of Los at 4, 8, and 10 dB signal to noise ratio (SNR), are 3.6×10⁻⁶, 6.03×10⁻¹³, and 2.66×10⁻¹⁸, respectively.

Keywords: visible light communication (VLC), field of view (FoV), hexagonal array, frequency reuse

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Authors: A. Kamel Abd Elaziz Mohamed, B. Sameh Kamal el Maraghi

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Introduction: Adaptive support ventilation (ASV) is an improved closed-loop ventilation mode that provides both pressure-controlled ventilation and PSV according to the patient’s needs. Aim of the work: To compare the short-term effects of Adaptive support ventilation (ASV), with conventional Pressure support ventilation (PSV) in weaning of intubated COPD patients. Patients and methods: Fifty patients admitted in the intensive care with acute exacerbation of COPD and needing intubation were included in the study. All patients were initially ventilated with control/assist control mode, in a stepwise manner and were receiving standard medical therapy. Patients were randomized into two groups to receive either ASV or PSV. Results: Out of fifty patients included in the study forty one patients in both studied groups were weaned successfully according to their ABG data and weaning indices. APACHE II score showed no significant difference in both groups. There were statistically significant differences between the groups in term of, duration of mechanical ventilation, weaning hours and length of ICU stay being shorter in (group 1) weaned by ASV. Re-intubation and mortality rate were higher in (group 11) weaned by conventional PSV, however the differences were not significant. Conclusion: ASV can provide automated weaning and achieve shorter weaning time for COPD patients hence leading to reduction in the total duration of MV, length of stay, and hospital costs.

Keywords: COPD patients, ASV, PSV, mechanical ventilation (MV)

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Authors: Nourhan G. Sahly, Ahmed Moustafa, Mohamed S. Zaghloul, Tamer Z. Salem

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The gut microbiome plays important roles in the human body that includes but not limited to digestion, immunity, homeostasis and response to some drugs such as chemotherapy and immunotherapy. Its role has also been linked to radiotherapy and associated gastrointestinal injuries, where the microbial dysbiosis could be the driving force for dose determination or the complete suspension of the treatment protocol. Linking the gut microbiota alterations to different cancer treatment protocols is not easy especially in humans. However, enormous effort was exerted to understand this complex relationship. In the current study, we described the gut microbiota dysbiosis in pediatric sarcoma patients, in the pelvic region, with regards to radiotherapy and antibiotics. Fecal samples were collected as a source of microbial DNA for which the gene encoding for V3-V5 regions of 16S rRNA was sequenced. Two of the three patients understudy had experienced an increase in alpha diversity post exposure to 50.4 Gy. Although phylum Firmicutes overall relative abundance has generally decreased, six of its taxa increased in all patients. Our results may indicate the possibility of radiosensitivity or enrichment of the antibiotic resistance of the elevated taxa. Further studies are needed to describe the extent of radiosensitivity with regards to antibiotic resistance.

Keywords: combined radiotherapy and chemotherapy, gut microbiome, pediatric cancer, radiosensitivity

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Authors: Kamel Abd Elaziz Mohamed, Ahmed Yehia Mousa, Ahmed Samir ElSawy, Adel Mohamed Saleem

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Introduction: Critically ill patients frequently require tracheostomy to simplify long term air way management. While tracheostomy indications have remained unchanged, the timing of elective tracheostomy for the ventilated patient has been questioned. Aim of the work: This study was performed to compare the differences between early and late percutaneous dilatational tracheostomy (PDT) regarding, mechanical ventilation duration (MVD), length of ICU stay, length of hospital stay, incidence of ventilator associated pneumonia and hospital outcome. Patients and methods: Forty patients who met the inclusion criteria were randomly divided into early PDT who had the tracheostomy within the first 10 days of mechanical ventilation (MV) and the late PDT who had the tracheostomy after 10 days of MV. On admission, demographic data and Acute Physiology and Chronic ill Health II and GCS were collected. The duration of mechanical ventilation, ICU length of stay (LOS) and hospital LOS were all calculated. Results: Total of 40 patients were randomized to either early PDT (n= 20) or late PDT (n= 20). There were no significant differences between both groups regarding demographic data or the scores: APACHE II (22.75± 7 vs 24.35 ± 8) and GCS (6.10 ±2 vs 7.10 ± 2.71). An early PDT showed fewer complications vs late procedure, however it was insignificant. There were significant differences between the two groups regarding mean (MVD) which was shorter in early PDT than the late PDT group (32.2± 10.5) vs (20.6 ± 13 days; p= 0.004). Mean ICU stay was shorter in early PDT than late PDT (21 .0± 513.4) vs (40.15 ±12.7 days; p 6 0.001). Mean hospital stay was shorter in early PDT than late PDT (34.60± 18.37) vs (55.60± 25.73 days; p=0.005). Patients with early PDT suffered less sepsis and VAP than late PDT, there was no difference regarding the mortality rate between the two groups. Conclusion: Early PDT is recommended for patients who require prolonged tracheal intubation in the ICU as outcomes like the duration of mechanical ventilation length of ICU stay and hospital stay were significantly shorter in early tracheostomy.

Keywords: intensive care unit, early PDT, late PDT, intubation

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Authors: Kamel Abd Elaziz Mohamed

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Introduction: Drug related problems (DRPs) are of major concern, affecting patients of both sex. They impose considerable economic burden on the society and the health-care systems. Aim of the work: The aim of this work was to identify and categorize drug-related problems in adult intensive care unit. Patients and methods: The study was a prospective, observational study as eighty six patients were included. They were consecutively admitted to ICU through the emergency room or transferred from the general ward due to DRPs. Parameters included in the study as length of stay in ICU, need for cardiovascular support or mechanical ventilation, dialysis, as well as APACHE II score were recorded. Results: Drug related problems represent 3.6% of the total ICU admission. The median (range) of APACHE II score for 86 patients included in the study was 17 (10-23), and length of ICU stay was 2.4 (1.5-4.2) days. In 45 patients (52%), DRP was drug over dose (group 1), while other DRP was present in the other 41 patients (48%, group 11). Patients in group 1 were older (39 years versus 32 years in group 11), with significant impaired renal function. The need of inotropic drugs and mechanical ventilation as well as the length of stay (LOS) in ICU was significantly higher in group 1. There were no significant difference in GCS between both groups, however APACHE II score was significantly higher in group 1. Only four patients (4.6%) were admitted by suicidal attempt as well as three patients (3.4%) due to trauma drug-related admissions, all were in (group 1). Nineteen percent of the patients had drug related problem due to hypoglycaemic medication followed by tranquilizer (15%). Adverse drug effect followed by failure to receive medication were the most causes of drug problem in (group11).The total mortality rate was 4.6%, all of them were eventually non preventable. Conclusion: The critically ill patients admitted due to drug related problems represented a small proportion (3.6%) of admissions to the ICU. Hypoglycaemic medication was one of the most common causes of admission by drug related problems.

Keywords: drug related problems, ICU, cost, safety

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Authors: Mutwakil Nafi, Abed Elaziz El Amein, Muna El Dawi, Khalafala Salih, Osma Elbahi, Abed Elhalim Abou

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Recently a large deposit of oolitic iron ore of Late Carboniferous-Permotriassic-Lower Jurassic age was discovered in Wadi Halfa and Argein areas, North Sudan. It seems that the iron ore mineralization exists in the west and east bank of the River Nile of the study area that are found on the Egyptian-Sudanese border. The Carboniferous-Lower Jurassic age strata were covered by 67 sections and each section has been examined and carefully described. The iron-ore in Wadi Halfa occurs as oolitic ironstone and contained two horizons: (A) horizon and (B) horizon. Only horizon (A) was observed in southern Argein area. The texture of the ore is variable depending on the volume of the component. In thin sections the average of the ooids were ranged between 90% - 80%. The matrix varies between 10%-20% by volume and detritus quartz in other component my reach up to 30% by volume in sandy massive ore. Ooids size ranges from 0.2mm-1.00 mm on average in very coarse ooids may attend up to 1 mm in size. The matrix around the ooids is dominated by iron hydroxide, carbonate, fine and amorphous silica. The probable ore reserve estimate of 1.234 billion at a head grade of 41.29% Fe for the Wadi Halfa Oolitic Ironstone Formation. The iron ore shows higher content of phosphorus ranges from 6.15% to 0.16%, with mean 1.45%. The new technology Hatch–Ironstone Chloride Segregation (HICS) can be used to produce commercial-quality of iron and reduce phosphorus and silica to acceptable levels for steel industry. The development of infra structures and presence huge quantity of iron ore would make exploitation of the iron ore economic.

Keywords: HICS, Late Carboniferous age, oolitic iron ore, phosphorus

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Authors: Manal Hassan Abdel Aziz, Fatma Mohamed Magdy Badr El Dine, Nourhan Mohamed Mohamed Saeed

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Establishing association between lip print patterns and those of fingerprints as well as blood groups is of fundamental importance in the forensic identification domain. The first aim of the current study was to determine the prevalent types of ABO blood groups, lip prints and fingerprints patterns in both studied populations. Secondly, to analyze any relation found between the different print patterns and the blood groups, which would be valuable in identification purposes. The present study was conducted on 60 healthy volunteers, (30 males and 30 females) from each of the studied population. Lip prints and fingerprints were obtained and classified according to Tsuchihashi's classification and Michael Kuchen’s classification, respectively. The results show that the ulnar loop was the most frequent among both populations. Blood group A was the most frequent among Egyptians, while blood groups O and B were the predominant among Malaysians. Significant relations were observed between lip print patterns and fingerprint (in the second quadrant for Egyptian males and the first one for Malaysian). For Malaysian females, a statistically significant association was proved in the fourth quadrant. Regarding the blood groups, 89.5% of ulnar loops were significantly related to blood group A among Egyptian males. The results proved an association between the fingerprint pattern and the lip prints, as well as between the ABO blood group and the pattern of fingerprints. However, further researches with larger sample sizes need to be directed to approve the current results.

Keywords: ABO, cheiloscopy, dactylography, Egyptians, Malaysians

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Authors: Ahmed Barakat, Nourhan Ahmed Saad, Mahmoud Hammad

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Tracking and monitoring agricultural products, cold chain activities, and transportation in real-time can effectively ensure both the quality and safety of agricultural products, as well as reduce overall logistics costs. Effective supply chain practices are one of the main requirements for enhancing agricultural business in Egypt. Cold chain is among the best practices for the storage and transportation of perishable goods and has potential within the agricultural sector in Egypt. This practice has the scope of reducing the wastage of food and increasing the profitability with a reduction in costs. Even though it has several implementation challenges for the farmers, traders, and people involved in the entire supply chain, it has highlighted better benefits for all and for the export of goods for the economic progression for Egypt. The aim of this paper is to explore cold supply chain practices for the agriculture sector in Egypt, to enhance the export performance of fresh goods. In this context, this study attempts to explore those aspects of the performance of cold supply chain practices that can enhance the functioning of the agriculture sector in Egypt from the perspective of export companies (traders) and farmers. Based on the empirical results obtained by data collection from the farmers and traders, the study argues that there is a significant association between cold supply chain practices and enhancement of the agriculture value chain. The paper thus highlights the contribution of the study with final conclusions and limitations with scope for future research.

Keywords: agriculture sector, cold chain management, export companies, non-traded goods, supply chain management

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Authors: Nourhan Elshenawi

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Net Neutrality (NN) is the principle of treating all online data the same without any prioritization of some over others. A research gap in current scholarship about “violations of NN” and the subsequent ethical concerns paves the way for the following research question: To what extent violations of NN entail ethical concerns and implications for Internet stakeholders? To answer this question, NR is examined using the two major action-based ethical theories, Kantian and Utilitarian, across the relevant Internet stakeholders. First some necessary IT background is provided that shapes how the Internet works and who the key stakeholders are. Following the IT background, the relationship between the stakeholders, users, Internet Service Providers (ISPs) and content providers is discussed and illustrated. Then some violations of NN that are currently occurring is covered, without attracting any attention from the general public from an ethical perspective, as a new term Net Regularity (NR). Afterwards, the current scholarship on NN and its violations are discussed, that are mainly from an economic and sociopolitical perspectives to highlight the lack of ethical discussions on the issue. Before moving on to the ethical analysis however, websites are presented as digital entities that are affected by NR and their happiness is measured using functionalism. The analysis concludes that NR is prone to an unethical treatment of Internet stakeholders in the perspective of both theories. Finally, the current Digital Divide in the world is presented to be able to better illustrate the implications of NR. The implications present the new Internet divide that will take place between individuals within society. Through answering the research question using ethical analysis, it attempts to shed some light on the issue of NR and what kind of society it would lead to. NR would not just lead to a divided society, but divided individuals that are separated by something greater than distance, the Internet.

Keywords: digital divide, digital entities, digital ontology, internet ethics, internet law, net neutrality, internet service providers, websites as beings

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Authors: Sayed M. Soleimani, Nader H. Ghareeb, Nourhan H. Shaker, Muhammad B. Siddiqui

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Honeycomb sandwich panels have been widely used as protective structural elements against blast loading. The main advantages of these panels include their light weight due to the presence of voids, as well as their energy absorption capability. Terrorist activities have imposed new challenges to structural engineers to design protective measures for vital structures. Since blast loading is not usually considered in the load combinations during the design process of a structure, researchers around the world have been motivated to study the behavior of potential elements capable of resisting sudden loads imposed by the detonation of explosive materials. One of the best candidates for this objective is the honeycomb sandwich panel. Studying the effects of explosive materials on the panels requires costly and time-consuming experiments. Moreover, these type of experiments need permission from defense organizations which can become a hurdle. As a result, modeling and simulation using an appropriate tool can be considered as a good alternative. In this research work, the finite element package ABAQUS® is used to study the behavior of hexagonal and squared honeycomb steel sandwich panels under the explosive effects of different amounts of trinitrotoluene (TNT). The results of finite element modeling of a specific honeycomb configuration are initially validated by comparing them with the experimental results from literature. Afterwards, several configurations including different geometrical properties of the honeycomb wall are investigated and the results are compared with the original model. Finally, the effectiveness of the core shape and wall thickness are discussed, and conclusions are made.

Keywords: Abaqus, blast loading, finite element modeling, steel honeycomb sandwich panel

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Authors: Nourhan A. Saad, Sara Elgazzar, Gehan Saleh

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The food industry nowadays is becoming customer-oriented and needs faster response time to deal with food incidents. There is a deep need for good traceability systems to help the supply chain (SC) partners to minimize production and distribution of unsafe or poor quality products, which in turn will enhance the food SC performance. The current food labeling systems implemented in developing countries cannot guarantee that food is authentic, safe and of good quality. Therefore, the use of origin labels, mainly the geographical indications (GIs), allows SC partners to define quality standards and defend their products' reputation. According to our knowledge there are no studies discussed the use of GIs in developing countries. This research represents a research schema about the implementation of European quality labeling system in developing countries and its impact on enhancing SC performance. An empirical study was conducted on the Egyptian traditional food sector based on a sample of seven restaurants implementing the Med-diet labeling system. First, in-depth interviews were carried out to analyze the Egyptian traditional food SC. Then, a framework was developed to link the European quality labeling system and SC performance. Finally, a structured survey was conducted based on the applied framework to investigate the impact of Med-diet labeling system on the SC performance. The research provides an applied framework linking Med-diet quality labeling system to SC performance of traditional food sector in developing countries generally and especially in the Egyptian traditional food sector. The framework can be used as a SC performance management tool to increase the effectiveness and efficiency of food industry's SC performance.

Keywords: food supply chain, med-diet labeling system, quality labeling system, supply chain performance

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Authors: Mervat Kassem, Nourhan Fanaki, F. Dabbous, Hamida Abou-Shleib, Y. R. Abdel-Fattah

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With increasing environmental awareness and emphasis on a sustainable society in harmony with the global environment, biosurfactants are gaining prominence and have already taken over for a number of important industrial uses. They are produced by living organisms, for examples Pseudomonas aeruginosa which produces rhamnolipids, Candida (formerly Torulopsis) bombicola, which produces high yields of sophorolipids from vegetable oils and sugars and Bacillus subtilis which produces a lipopeptide called surfactin. The main goal of this work was to optimize biosurfactants production by an environmental Gram positive isolate for large scale production with maximum yield and low cost. After molecular characterization, phylogenetic tree was constructed where it was found to be B. subtilis, which close matches to B. subtilis subsp. subtilis strain CICC 10260. For optimizing its biosurfactants production, sequential statistical design using Plackett-Burman and response surface methodology, was applied where 11 variables were screened. When analyzing the regression coefficients for the 11 variables, pH, glucose, glycerol, yeast extract, ammonium chloride and ammonium nitrate were found to have a positive effect on the biosurfactants production. Ammonium nitrate, pH and glucose were further studied as significant independent variables for Box-Behnken design and their optimal levels were estimated and were found to be 7.328 pH value, 3 g% glucose and 0.21g % ammonium nitrate yielding high biosurfactants concentration that reduced the surface tension of the culture medium from 72 to 18.16 mN/m. Next, kinetics of cell growth and biosurfactants production by the tested B. subtilis isolate, in bioreactor was compared with that of shake flask where the maximum growth and specific growth (µ) in the bioreactor was higher by about 25 and 53%, respectively, than in shake flask experiment, while the biosurfactants production kinetics was almost the same in both shake flask and bioreactor experiments.

Keywords: biosurfactants, B. subtilis, molecular identification, phylogenetic trees, Plackett-Burman design, Box-Behnken design, 16S rRNA

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Authors: A. M. Nour, M. A. Zaki, E. A. Omer, Nourhan Mohamed

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Performances of mixed-sex Nile tilapia (Oreochromis niloticus) fingerlings (11.33 ± 1.78 g /fish) reared under biofloc system developed by molasses and sucrose as carbon sources in indoor fiberglass tanks were evaluated. Six indoor fiberglass tanks (1m 3 each filled with 1000 l of underground fresh water), each was stocked with 2kg fish were used for 14 weeks experimental period. Three experimental groups were designed (each group 2 tanks) as following: 1-control: 20% daily without biofloc, 2-zero water exchange rate with biofloc (molasses as C source) and 3-zero water exchange rate with biofloc (sucrose as C source). Fish in all aquariums were fed on floating feed pellets (30% crude protein, 3 mm in diameter) at a rate of 3% of the actual live fish body, 3 times daily and 6 days a week. Carbohydrate supplementations were applied daily to each tank two hrs, after feeding to maintain the carbon: nitrogen ratio (C: N) ratio 20:1. Fish were reared under continuous aeration by pumping air into the water in the tank bottom using two sandy diffusers and constant temperature between 27.0-28.0 ºC by using electrical heaters for 10 weeks. Criteria's for assessment of water quality parameters, biofloc production and fish growth performances were collected and evaluated. The results showed that total ammonia nitrogen in control group was higher than biofloc groups. The biofloc volumes were 19.13 mg/l and 13.96 mg/l for sucrose and molasses, respectively. Biofloc protein (%), ether extract (%) and gross energy (kcal/100g DM), they were higher in biofloc molasses group than biofloc sucrose group. Tilapia growth performances were significantly higher (P < 0.05) with molasses group than in sucrose and control groups, respectively. The highest feed and nutrient utilization values for protein efficiency ratio (PER), protein productive (PPV%) and energy utilization (EU, %) were higher in molasses group followed by sucrose group and control group respectively.

Keywords: biofloc, Nile tilapia, cabohydrates, performances

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Authors: Sobhy A. El-Sohaimy, Mohamed G. Shehata, Ashwani Mathur, Amira G. Darwish, Nourhan M. Abd El-Aziz, Pammi Gauba, Pooja Upadhyay

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Sea buckthorn is a temperate bush plant native to Asian and European countries, explored across the world in traditional medicine to treat various diseases due to the presence of an exceptionally high content of phenolics, flavonoids and antioxidants. In addition to the evaluation of nutrients and active compounds, the focus of the present work was to assess the optimal levels for L. plantarum RM1 growth by applying response surface methodology (RSM), and to determine the impact of juice fermentation on antioxidant, anti-hypertension and anticancer activity, as well as on organoleptic properties. Sea buckthorn berries were shown to contain good fiber content (6.55%, 25 DV%), high quality of protein (3.12%, 6.24 DV%) containing: histidine, valine, threonine, leucine and lysine (with AAS 24.32, 23.66, 23.09, 23.05 and 21.71%, respectively), and 4.45% sugar that pro- vides only 79 calories. Potassium was shown to be the abundant mineral content (793.43%, 22.66 DV), followed by copper and phosphorus (21.81 and 11.07 DV%, respectively). Sea buckthorn juice exhibited a rich phenolic, flavonoid and carotenoid content (283.58, 118.42 and 6.5 mg/g, respec- tively), in addition to a high content of vitamin C (322.33 mg/g). The HPLC profile indicated that benzoic acid is the dominant phenolic compound in sea buckthorn berries (3825.90 mg/kg). Antiox- idant potentials (DPPH and ABTS) of sea buckthorn showed higher inhibition than ascorbic acid. Antimicrobial potentials were most pronounced against Escherichia coli BA12296 (17.46 mm). The probiotic growth was 8.5 log cfu/mL, with juice concentration, inoculum size and temperature as the main contributors to probiotic growth with a 95% confidence level. Fermentation of sea buck- thorn juice with L. plantarum RM1 enhanced the functional phenolic and flavonoid content, as well as antioxidant and antimicrobial activities. The fermentation with L. plantarum RM1 enhanced the anti-hypertension and anticancer properties of the sea buckthorn juice and gained consumers’ sensorial overall acceptance.

Keywords: sea buckthorn juice, L. plantarum RM1, fermentation, antioxidant, antimicrobial, angiotensin converting enzyme inhibition

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Authors: M. G. Shehata, S. A. El Sohaimy, Marwa M. Abu-Serie, Nourhan M. Abd El-Aziz

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Probiotic strains can potentially be used as bio-preservatives and functional food supplement. Eight lactic acid bacteria strains (LAB) Lactobacillus brevis NRRL B-4527; Streptococcus thermophilus BLM 58; Pediococcusacidilactici ATCC 8042; Lactobacillus rhamnosus CCUG 1452; Lactobacillus curvatus ATCC 51436; Lactococcuslactis sub sp. lactisDSM 20481; Lactobacillus plantarum DMSZ 20079 and Lactobacillus plantarumTF103 were selected to screen the antioxidant, anticancer potential and probiotic properties. LAB strains exhibited good probiotic, antioxidant properties and showed antagonistic activity against food-borne pathogenic (Bacillus subtilis DB 100 host; Candida albicans ATCCMYA-2876; Clostridium botulinum ATCC 3584; Escherichia coli BA 12296; Klebsiellapneumoniae ATCC12296; Salmonella senftenberg ATCC 8400 and Staphylococcus aureus NCTC 10788). Further, in vitro probiotic properties of eight strains displayed excellent acid tolerance, bile tolerance, simulated gastrointestinal juice tolerance, in vitro adhesion ability for HT-29 cell line. The antioxidant effect of intracellular and cell-free extract of lactic acid bacteria strains was evaluated by various antioxidant assays, namely, resistance to hydrogen peroxide, DPPH radical scavenging, ABTS radical scavenging, and hydroxyl radical scavenging (HRS). The results showed that intracellular and cell-free supernatant of S. Thermophilus BLM 58, L. lactissubsp.lactis DSM 20481, P. acidilactici ATCC 8042, L. brevis NRRL B-4527 strains possess excellent antioxidant capacity. The intracellular of S. Thermophilus BLM 58 and P. acidilactici ATCC 8042 also showed excellent anticancer activity against Caco-2, MCF-7, HepG-2, and PC-3. Antioxidative property of selected lactic acid bacteria strains would be useful in the functional food manufacturing industry. They could beneficially affect the consumer by providing dietary source of antioxidants.

Keywords: anticancer activity, antioxidant activity, functional food, lactic acid bacteria, probiotic

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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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