AQU researchers publications

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31P-NMR and differential scanning calorimetry studies for determining vesicles drug physical state and fraction in alendronate liposomes
(OMICS Publishing Group, 2010-10-15) Afergan, Eyal; Najajreh, Yousef; Gutman, Dikla; Epstein, Hila; Elmalak, Omar; Golomb, Gershon
Background: A liposomal delivery system requires a complete understanding of the physicochemical characteristics of the drug– liposome system in order to predict their behavior and stability in-vitro and in-vivo. Objectives: Develop a rapid and simple experimental method to determine the fractions of the drug, alendronate (ALN), encapsulated and as a free form distributed in the liposomal suspension, and the physical state of the encapsulated drug. Methods: 31P-NMR measurements utilizing Ga+3 as a shifting reagent in comparison to HPLC determinations, theoretical calculations and differential scanning calorimetry (DSC) studies of various liposomal ALN formulations. Results: The 31P-NMR demonstrated that titrating liposomal ALN with increasing amounts of Ga+3 induced a signifi cant shift in the exterior fraction without changing the interior fraction. Quantitative determination of the encapsulated and non-encapsulated fractions of ALN has been achieved at Ga+3 concentrations of 3.2-25mM. The DSC study revealed that none of the formulation ingredients is in a solid phase. Conclusions: 31P-NMR was found to be sensitive enough to allow accurate differentiation of the distributed fractions of ALN, encapsulated and the non-encapsulated free form. Based on theoretical calculations and DSC analysis it can be concluded that ALN is dissolved in the aqueous core of the liposome.
50 years of professional public health workforce development. ASPHER's 50th Anniversary Book
(The Association of Schools of Public Health in the European Region (ASPHER), 2016-05-20) M., Hamdan
The Association of Schools of Public Health in the European Region (ASPHER) is the key independent European organisation dedicated to strengthening the role of public health by improving education and training of public health professionals for both practice and research. ASPHER is a membership organisation of institutions, spread across EU and wider across WHO European Region, which are collectively concerned with the education and training, and professionalism, of those entering and working within the public health workforce
A Bias-Free Time-Aware PageRank Algorithm for Paper Ranking in Dynamic Citation Networks
(Intelligent Information Management, 2022-02-22) Abu Dayeh, Moath; Sartawi, Badie; Salah, Saeed
The process of ranking scientific publications in dynamic citation networks plays a crucial rule in a variety of applications. Despite the availability of a number of ranking algorithms, most of them use common popularity metrics such as the citation count, h-index, and Impact Factor (IF). These adopted metrics cause a problem of bias in favor of older publications that took enough time to collect as many citations as possible. This paper focuses on solving the problem of bias by proposing a new ranking algorithm based on the PageRank (PR) algorithm; it is one of the main page ranking algorithms being widely used. The developed algorithm considers a newly suggested metric called the Citation Average rate of Change (CAC). Time information such as publication date and the citation occurrence’s time are used along with citation data to calculate the new metric. The proposed ranking algorithm was tested on a dataset of scien tific papers in the field of medical physics published in the Dimensions data base from years 2005 to 2017. The experimental results have shown that the proposed ranking algorithm outperforms the PageRank algorithm in ranking scientific publications where 26 papers instead of only 14 were ranked among the top 100 papers of this dataset. In addition, there were no radical changes or unreasonable jump in the ranking process, i.e., the correlation rate between the results of the proposed ranking method and the original PageRank algo rithm was 92% based on the Spearman correlation coefficient
A case of uniportal VATS thymectomy for Thymoma associated with myasthenia gravis and toxic multinodular goiter
(ELSEVIER, 2022-05-11) Osama N. Dukmak; Ruba Dweik; Nadeen Hashlamoun; Rahaf Qawasmeh; Mohammad Eid Al Mohtasib; Yousef Abu Asbeh
Background: Thymoma is a rare neoplasm, which may be associated with autoimmune disorders, the occurrence of hyperthyroidism in the patients with thymoma is rare. Clinical presentation: Here we present an extremely rare case of a 56-year-old female patient who was discovered to have malignant thymoma with associated myasthenia gravis and hyperthyroidism due to toxic multinodular goiter. Our patient started to complain of difficulty breathing and swallowing, Chest CT scan was done and revealed an anterior mediastinal mass, measures about 4.1 × 3.1 × 2.2 cm with enlarged lymph node mostly representing thymoma. Complete thymectomy was performed via uniportal video-assisted thoracoscopic surgery, and the patient's postoperative recovery was uneventful. Microscopic histopathology findings corresponded to thymoma type B1. Conclusion: The coexistence of thymoma, MG and toxic multinodular goiter is extremely rare. MG should always be suspected in a patient with thymoma. VATS thymectomy has been increasingly used to treat thymoma as it has several advantages over open surgery.
A comparative study for lead removal by pure calcite and a natural calcitic soil sample
(Springer, 2023-03-05) M. Alkhatib; O. Ayyad; R. Tbakhi; M. Qurie
The extent of removing toxic lead ions (Pb2+) from aqueous solutions was investigated using pure calcite and natural calcitic soil, one of the globally available soils, as efective inorganic adsorbents. The rate of adsorption of Pb2+ ions on pure calcite is much faster than that on the soil sample due to the presence of other metal ions on its surface, which block the active sites and retard the adsorption process. The order of adsorption on the soil was a frst-order reaction with respect to Pb2+ ions. The rate constant was calculated to be 0.1 min−1. The half-life time of the adsorption of Pb2+ ions on soil was calculated to be 6.9 min at 25 °C. The adsorption process on both solids fts well with the Langmuir isotherm but does not ft well with the Temkin or Freundlich isotherms. Maximum adsorption capacities were calculated from the Langmuir isotherm as 156 mg/g calcite and 74 mg/g soil at 25 °C.
A comparative study of five numerical methods for the estimation of Weibull parameters for wind energy evaluation at Eastern Jerusalem, Palestine
(ELSEVIER, 2022-04-16) Husain R. Alsamamra; Saeed Salah; Jawad A.H. Shoqeir; Ali J. Manasra
Wind power provides a clean and feasible solution to generate electricity. The development of wind power applications requires a deep analysis of wind profiles and an accurate prediction of wind energy at a study site. This work explores the distribution of wind speed to estimate the two Weibull parameters (shape and scale) that are widely utilized for modeling and providing an accurate and efficient estimation of wind resource and power. These two parameters are calculated based on measured daily wind speed data from 2008 to 2018, collected in Jerusalem, Palestine. Three assessment criteria were used to assess the goodness of fit; they are Root Mean Square Error (RMSE), Mean Absolute Percentage Error (MAPE), and chi-square. The findings revealed that of the five estimation methods being considered in this study, both the Empirical Method (EM) and the Method of Moment (MoM) were the most accurate in determining the values of the Weibull shape and scale parameters to approximate wind speed distribution at the study site. Based on the goodness-of-fit tests, both methods provide lower values of the used assessment criteria. The statistical performance tests rejected the Energy Pattern Factor Method (EPFM) as an adequate method due to the higher values of chi-square and revealed that the Maximum Likelihood (MLM) and the Modified Maximum Likelihood (MMLM) methods ranked third and fourth, respectively.
A Mathematical-Based Model for Estimating the Path Duration of the DSDV Routing Protocol in MANETs
(MDPI, 2022-05-12) Saeed Salah; Raid Zaghal; Mada Abdeljawad
Mobile Ad Hoc Networks (MANETs) are kind of wireless networks where the nodes move in decentralized environments with a highly dynamic infrastructure. Many well-known routing protocols have been proposed, with each having its own design mechanism and its own strengths and weaknesses and most importantly, each protocol being mainly designed for specific applications and scenarios. Most of the research studies in this field used simulation testbeds to analyze routing protocols. Very few contributions suggested the use of analytical studies and mathematical approaches to model some of the existing routing protocols. In this research, we have built a comprehensive mathematical-based model to analyze the Destination-Sequenced Distance Vector protocol (DSDV), one of the main widely deployed proactive protocols and studied its performance on estimating the path duration based on the concepts of the probability density function and the expected values to find the best approximation values in real scenarios. We have tested the validity of the proposed model using simulation scenarios implemented by the Network Simulator tool (NS3). The results extracted from both the mathematical model and the simulation have shown that the path duration is inversely proportional to both the speed of the node and the hop count. Furthermore, it had shown that the path duration estimated from the DSDV protocol is less than the actual path duration, due to the implementation of the settling time concept and keeping the “periodic routes’ update” parameter at a constant level, despite the fact that the node’s speed reduces the effective path utilization.
A multi-centre study of candidate genes for wheeze and allergy: the International Study of Asthma and Allergies in Childhood Phase 2
(Clin Exp Allergy., 2009-11-30T22:00:00Z) Genuneit, J; Cantelmo, J L; Weinmayr, G; Wong, G W K; Cooper, P J; Riikjärv, M-A; Gotua, M; Kabesch, M; von Mutius, E; Forastiere, F; Crane, J; Nystad, W; El-Sharif, N; Batlles-Garrido, J; García-Marcos, L; García-Hernández, G; Morales-Suarez-Varela, M; Nilsson, L; Bråbäck, L; Saraçlar, Y; Weiland, S K; Cookson, W O C; Strachan, D; Moffatt, M F; ISAAC Phase 2 Study Group
Background: Common polymorphisms have been identified in genes suspected to play a role in asthma. We investigated their associations with wheeze and allergy in a case-control sample from Phase 2 of the International Study of Asthma and Allergies in Childhood. Methods: We compared 1105 wheezing and 3137 non-wheezing children aged 8-12 years from 17 study centres in 13 countries. Genotyping of 55 candidate single nucleotide polymorphisms (SNPs) in 14 genes was performed using the Sequenom System. Logistic regression models were fitted separately for each centre and each SNP. A combined per allele odds ratio and measures of heterogeneity between centres were derived by random effects meta-analysis. Results: Significant associations with wheeze in the past year were detected in only four genes (IL4R, TLR4, MS4A2, TLR9, P<0.05), with per allele odds ratios generally <1.3. Variants in IL4R and TLR4 were also related to allergen-specific IgE, while polymorphisms in FCER1B (MS4A2) and TLR9 were not. There were also highly significant associations (P<0.001) between SPINK5 variants and visible eczema (but not IgE levels) and between IL13 variants and total IgE. Heterogeneity of effects across centres was rare, despite differences in allele frequencies. Conclusions: Despite the biological plausibility of IgE-related mechanisms in asthma, very few of the tested candidates showed evidence of association with both wheeze and increased IgE levels. We were unable to confirm associations of the positional candidates DPP10 and PHF11 with wheeze, although our study had ample power to detect the expected associations of IL13 variants with IgE and SPINK5 variants with eczema.
A multi-centre study of candidate genes for wheeze and allergy: the International Study of Asthma and Allergies in Childhood Phase 2
(Clin Exp Allergy ., 2009-11-30T22:00:00Z) Genuneit, J; Cantelmo, J L; Weinmayr, G; Wong, G W K; Cooper, P J; Riikjärv, M-A; Gotua, M; Kabesch, M; von Mutius, E; Forastiere, F; Crane, J; Nystad, W; El-Sharif, N; Batlles-Garrido, J; García-Marcos, L; García-Hernández, G; Morales-Suarez-Varela, M; Nilsson, L; Bråbäck, L; Saraçlar, Y; Weiland, S K; Cookson, W O C; Strachan, D; Moffatt, M F; ISAAC Phase 2 Study Group
Background: Common polymorphisms have been identified in genes suspected to play a role in asthma. We investigated their associations with wheeze and allergy in a case-control sample from Phase 2 of the International Study of Asthma and Allergies in Childhood. Methods: We compared 1105 wheezing and 3137 non-wheezing children aged 8-12 years from 17 study centres in 13 countries. Genotyping of 55 candidate single nucleotide polymorphisms (SNPs) in 14 genes was performed using the Sequenom System. Logistic regression models were fitted separately for each centre and each SNP. A combined per allele odds ratio and measures of heterogeneity between centres were derived by random effects meta-analysis. Results: Significant associations with wheeze in the past year were detected in only four genes (IL4R, TLR4, MS4A2, TLR9, P<0.05), with per allele odds ratios generally <1.3. Variants in IL4R and TLR4 were also related to allergen-specific IgE, while polymorphisms in FCER1B (MS4A2) and TLR9 were not. There were also highly significant associations (P<0.001) between SPINK5 variants and visible eczema (but not IgE levels) and between IL13 variants and total IgE. Heterogeneity of effects across centres was rare, despite differences in allele frequencies. Conclusions: Despite the biological plausibility of IgE-related mechanisms in asthma, very few of the tested candidates showed evidence of association with both wheeze and increased IgE levels. We were unable to confirm associations of the positional candidates DPP10 and PHF11 with wheeze, although our study had ample power to detect the expected associations of IL13 variants with IgE and SPINK5 variants with eczema.
A multinational study of treatment failures in asthma management
(Int J Tuberc Lung Dis ., 2007-12-31T22:00:00Z) Burney, P; Potts, J; Aït-Khaled, N; Sepulveda, R M D; Zidouni, N; Benali, R; Jerray, M; Musa, O A A; El-Sony, A; Behbehani, N; El-Sharif, N; Mohammad, Y; Khouri, A; Paralija, B; Eiser, N; Fitzgerald, M; Abu-Laban, R
EmSetting: Emergency rooms. Objective: To assess quality of care and its determinants for asthma patients before emergency room treatment. Design: Consecutive patients with acute severe asthma attending emergency rooms were questioned about the severity of their disease and treatment in the previous 4 weeks. Prescriptions of inhaled corticosteroids were recorded. Other outcomes included self-reported adherence to treatment and loss of work. Results: Thirteen centres in 11 countries recruited 1156 patients. Only 36% of patients with persistent asthma had been prescribed an adequate dose of inhaled corticosteroids. This percentage improved in those receiving regular care from the same doctor (OR 2.86, 95%CI 1.38-5.96), and was at least as good for the 10% of patients receiving 'private' health care (OR 3.08, 95%CI 1.69-5.62). Forty-four per cent of patients had health insurance covering some asthma medications. These patients were more likely to be receiving adequate inhaled corticosteroids (OR 1.74, 95%CI 1.17-2.58), and reported better adherence than those without insurance (OR 3.00, 95%CI 1.64-5.50). Of those on adequate inhaled corticosteroids, 18% had lost work in each of the 4 previous weeks compared with 59% among those more than one treatment step below the recommended dose.ergency rooms. Conclusions: Access to adequate treatment is critical for better management of asthma.
A New Data-Balancing Approach Based on Generative Adversarial Network for Network Intrusion Detection System
(MDPI, 2023-06-20) Mohammad Jamoos; Antonio M. Mora; Mohammad AlKhanafseh; Ola Surakhi
An intrusion detection system (IDS) plays a critical role in maintaining network security by continuously monitoring network traffic and host systems to detect any potential security breaches or suspicious activities. With the recent surge in cyberattacks, there is a growing need for auto-mated and intelligent IDSs. Many of these systems are designed to learn the normal patterns of network traffic, enabling them to identify any deviations from the norm, which can be indicative of anomalous or malicious behavior. Machine learning methods have proven to be effective in detecting malicious payloads in network traffic. However, the increasing volume of data generated by IDSs poses significant security risks and emphasizes the need for stronger network security measures. The performance of traditional machine learning methods heavily relies on the dataset and its balanced distribution. Unfortunately, many IDS datasets suffer from imbalanced class distributions, which hampers the effectiveness of machine learning techniques and leads to missed detection and false alarms in conventional IDSs. To address this challenge, this paper proposes a novel model-based generative adversarial network (GAN) called TDCGAN, which aims to improve the detection rate of the minority class in imbalanced datasets while maintaining efficiency. The TDCGAN model comprises a generator and three discriminators, with an election layer incorporated at the end of the architecture. This allows for the selection of the optimal outcome from the discriminators’ outputs. The UGR’16 dataset is employed for evaluation and benchmarking purposes. Various machine learning algorithms are used for comparison to demonstrate the efficacy of the proposed TDCGAN model. Experimental results reveal that TDCGAN offers an effective solution for addressing imbal-anced intrusion detection and outperforms other traditionally used oversampling techniques. By leveraging the power of GANs and incorporating an election layer, TDCGAN demonstrates superior performance in detecting security threats in imbalanced IDS datasets.
A rare association between crossed fused renal ectopia, urethral stricture, bilateral cryptorchidism, and sub-coronal hypospadias in a non-syndromic 6-year-old child
(Elsevier, 2023-01-10) Oadi N. Shrateh; Afnan W. M. Jobran; Saja Jaber; Ahmad Kahla; Mohammad Shker; Wael Abu Arafeh
Introduction: From asymptomatic ectopic kidneys to potentially fatal renal agenesis, congenital abnormalities of the kidney and urinary tract (CAKUT) encompass a wide variety of anomalies (bilateral). With varied degrees of severity, many of them are found in the antenatal or immediately postnatal period, with a sizable fraction also found in the adult population. On the basis of embryology, CAKUT can be divided into three categories: defects in the formation of the renal parenchyma, aberrant embryonic migration, and abnormalities of the collecting system. Multiple cystic dysplastic kidneys, renal hypoplasia, number (agenesis or supernumerary), form, and cystic renal illnesses are examples of renal parenchymal abnormalities. Case presentation: A 6-year-old male patient was referred to the hospital complaining of painful and difficult urination. Past medical history was significant for recurrent urinary tract infections, with temporary improvement with antibiotic therapy. Physical assessment and imaging evaluation revealed a constellation of genitourinary anomalies, including sub-coronal hypospadias, penile urethral stricture, bilateral cryptorchidism, and a crossed fused ectopic left kidney. Discussion and conclusion: Congenital kidney and urinary tract anomalies are a group of several diseases that affect the kidney and/or urinary tract. Despite substantial differences in phenotypic and clinical consequences, CAKUT has a similar genetic foundation and shares molecular signals that influence kidney development. The prognosis and quality of life for affected families have improved thanks to advancements in prenatal diagnostics, imaging, genetic testing, laboratory surveillance, and medical management, as many of these congenital defects are inherited.
Accelerations in the Lactonization of Trimethyl Lock Systems Aredue to Proximity Orientation and not to Strain Effects
(Hindawi Publishing Corporation, 2009-02-10) Karaman, Rafik
DFT at B3LYP/6-31G(d, p) and HF at 6-31G and AM1 semiempirical calculations of thermodynamc and kinetic parameters for the trimethyl lock system (an important enzyme model) indicate that the remarkable enhancement in the lactonizations is largely the result of a proximity orientation as opposed to the currently advanced strain effect.
Access to fludrocortisone and to hydrocortisone in children with congenital adrenal hyperplasia in the WHO Eastern Mediterranean Region: it takes a village
(2021-10-20) Amanda Rowlands; Asma Deeb; Asmahane Ladjouze; Rasha T Hamza; Salwa A Musa; Jamal Raza; Farida Jennane; Abdulsalam Abu-Libdeh; Jean-Pierre Chanoine; GPED CAH Working
Congenital adrenal hyperplasia (CAH), if untreated, carries high morbidity and mortality. A higher incidence of CAH is expected in countries where consanguinity is common, such as in the countries of the WHO Eastern Mediterranean Region (EMRO). CAH is managed through lifelong treatment with fludrocortisone and hydrocortisone. In this analysis, performed in the 22 EMRO countries and territories plus Algeria, we review which countries offer a neonatal screening programme for CAH and describe the barriers and opportunities to access oral fludrocortisone and oral and injectable hydrocortisone. Neonatal CAH screening was only available nationally in Qatar, Kuwait and partially in Lebanon and Saudi Arabia. We reviewed the national lists of essential medicines (NEMLs) and found that 13/23 (57%) countries included fludrocortisone and 18/23 (78%) included oral hydrocortisone. Fludrocortisone was not included by any of the low-income countries and oral hydrocortisone was only included by one low-income country. We then contacted paediatric endocrinologists in each country to assess perceived availability of these medicines. Overall, there was a relatively good consistency between inclusion of fludrocortisone and hydrocortisone in the NEML and their actual availability in a country. We propose several mechanisms to improve access, including prequalification by the WHO, a common registration process for groups of countries, pooled procurement, working with local pharmaceutical companies, special access status for medicines not yet registered in a country and compounding. We suggest that access to medicines requires a collaboration between health professionals, families of patients, health authorities, pharmaceutical companies and the WHO.
Accuracy of Intracavitary Applicator Reconstruction for Cervix Cancer Brachytherapy
(Springer, 2019-12-03) ALMasri, Hussein; Kakinohana, Yasumasa; Toita, Takafumi; Ariga, Takuro; Kasuya, Goro; Murayama, Sadayuki
The accuracy of intracavitary applicator reconstruction for cervical cancer was assessed. A homemade phantom that mimics clinical applicator placement and reference points was used. Three stainless steel (15°, 30°, and 45°) tandems, x-ray markers, and three reference points were used to compare radiography- and CT-based systems. For CT reconstructions, two Fletcher CT compatible (15° and 30°) tandems, two ovoids, and two reference points, with and without inserted x-ray markers, were used. A 2.5-mm CT slice thickness was used. To check for inter- and intra-operator variations in CT, only a 30° tandem without x-ray markers and 1.25-mm CT slice thickness were used. Applicators were reconstructed three times for each image set to verify the operator reproducibility. A 6 Gy dose was prescribed and normalized at AL-point. Source dwell times were compared to check for dose variation at A-point. Maximum standard deviations SD (σ) for radiography and CT reconstructions were 0.35 and 0.83mm, respectively. Analysis of variance for the means of 15° and 30° tandems showed no significant difference. Levene’s test proved insignificant difference for 15° tandem (p value = 0.131), whereas it showed a significant difference for 30° tandem (p value = 0.011). This phantom study showed that the variance of dwell times between the two methods for 30° tandem was statistically significant due to increased applicator curvature. CT proves superiority to radiography. X-ray marker method was more accurate but has less image quality. Inter- and intra-oncologist variations showed good agreement.
The Achievement of Both Justice and Consent in Financial Transaction Contracts
(2020-10-20) Assaf, Mohammad Motleq Mohammad
This study clarifies that the basis on which contracts are established is mutual consent, whereby property shall not be taken away from a person without their consent. The indication of mutual consent is the apparent wording of offer and acceptance under the condition of the absence of coercion that cancels consent. This coercion is illegal coercion that is unjust and that unlawfully infringes the right of others to exercise free will. However, if the opposite occurs, namely, if the right of agreement and consent in a contract leads to injustice or harm to others, then achieving both justice and consent by using coercion is the right thing to do. This type of coercion aims to achieve a rightful purpose that ensures justice and eliminates injustice and provides for restitution as well.
Achievements and barriers of renewable energy in Palestine: Highlighting Oslo Agreement as a barrier for exploiting RE resources
(Elsevier Ltd., 2021-06-01) Abboushi, Nour; Alsamamra, Husain
Oslo agreement was signed in 1993 between the Palestinians and the Israelis as a gesture of hope for the autonomy of the Palestinians on their lands. Palestinians lands was divided into three administrative regions: Areas A, B, and C. These divisions were signed as a temporary transitional period of 5 years, during which the transfer of control over areas C and B to the Palestinian National Authority, was not implemented until the time of writing this research. This work aims to shed light on the impact of the geopolitical division on the possibility of exploiting renewable energy resources on C areas, and the role of that in achieving the Palestinian vision of reducing total dependency on the Israeli side as a net importer of Energy. To conclude, 96% of the total potential of solar energy is in West Bank, while Gaza has only 163 MW. Area C obsesses over 62% of solar energy potential, while about 75% of the potential in area (A þ B) is upon the roof tops. It is expected, 98% of the total renewable energy potential is solar energy potential. Only 0.12% of the total A and B lands are suitable for producing solar electricity.
Acidic whey as a novel coupling agent for composites based on E-Glass fibers and low-density polyethylene
(An-Najah University, 2022-02-02) Shadi Sawalha; Raed Ma’ali; Hussein Mushatti; Mohammad Makharzeh
In order to enhance the interfacial-adhesion between short E-glass fibers and low-density polyethylene (LDPE), acidic whey; a dairy byproduct was applied as coupling agent. The fibers were immersed in acidic whey for 12, 24, 36, 48 and 60 hours. Composite materials containing 20 wt.% E- glass fibers and LDPE were prepared by extrusion process. The tensile strength and modulus of the produced composites were improved by using acidic whey, and the improvement in those properties was strongly affected by the immersion time of E-glass fibers in acidic whey. An increase of about 289%, 107%, 291% and 721% in modulus of elasticity, tensile strength, modulus efficiency and strength efficiency factors respectively were achieved after 60 hours of immersion of glass fibers in acidic whey. The effects of acidic whey on tensile properties and efficiency factors could be ascribed to the mend in interfacial-dhesion between glass fibers and LDPE polymer.
Acinetobacterlwoffii Induced Cellulitis with Allergy-like Symptoms
(Internet Scientific Publications, 2012-01-10) Barghouthi, S.; Hammad, G.; Kurdi, M.
Few reports document the misdiagnosis of Acinetobacterlwoffii skin infections for allergic reactions. In addition, A. lwoffii is frequently misidentified when applying conventional diagnostic methods. The bacterium has been reported to cause a multitude of diseases including skin and wound infections. The application of the newly established method “The Universal Method” allowed definite identification of the bacterium isolated from a leg and foot cellulitis case (Isolate QUBC mk1) that was misdiagnosed as an allergic reaction and was treated with intramuscular injections of diclofeneac sodium, anonsteroidal antiinflammatory drug.The isolate was identified as A. lwoffii, it failed to grow on MacConkey agar, and it was sensitive to ciprofloxacin but resistant to cefazolin. The 51-year old male patient was successfully treated with intravenous administration of ciprofloxacin, doxacillin, and cefazolin. He was released in good health after ten days.This work emphasizes the importance of distinguishing between skin infections and allergies. It also stresses the importance of prompt and accurate identification of A. Lwoffii and its possible relationship to allergic reactions. Misdiagnosis isdiscussed in the context of “The Hygiene Hypothesis”.
Acute pancreatitis with giant pancreatic pseudocyst as a complication of extracorporeal shock wave lithotripsy: A case report and literature review
(2021-05-26) Alzeerelhouseini, Hussam I.A.; Abuzneid, Yousef S.; Ashhab, Hazem A.
ntroduction: Extracorporeal shock wave lithotripsy has been confirmed as the least invasive and the most widely used treatment for kidney and ureteral stones. However, as with any other type of therapy, potential compli-cations do exist. Case presentation: Herein, we describe a 55-year-old male patient who developed symptoms of acute pancreatitis one day after extracorporeal shock wave lithotripsy for left renal stones. The patient used to manage himself with NSAIDs till he presented to the emergency department with severe epigastric pain and tenderness due to giant pancreatic pseudocyst formation. The pseudocyst was treated by endoscopic cystogastrostomy using metallic stent with uneventful recovery. In addition, we extensively reviewed all available literature studies of pancre-atitis and pancreatic pseudocyst occurring after extracorporeal shock wave lithotripsy. We summarized all re-ported cases and presented them in a comprehensive table. Discussion: Post ESWL acute pancreatitis is a rare clinical entity with only 11 reported cases. In all cases, abdominal pain was the most common symptom that occurs in less than 24h following ESWL treatment. So it should be considered in the differential diagnosis of acute abdominal pain after ESWL. Conclusion: Although ESWL is generally considered safe and effective treatment; however, major complications have been reported to occur in less than 1% of patients. One of the extremely rare complications is the devel-opment of pancreatitis and pancreatic pseudocyst.

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