Coynealdridge0629

Bereaved siblings experience more externalizing problems compared to non-bereaved peers and norms; however, the mechanisms explaining this phenomenon have not been empirically examined. This study tested the serial indirect effects of sibling bereavement on adolescents' externalizing problems through parent distress (i.e., internalizing symptoms) and parenting (i.e., parenting behaviors, parent-adolescent communication).

During home visits, 72 bereaved adolescents (ages 10-18) whose brother/sister died from cancer and 60 comparison peers reported about their externalizing problems and their mothers' and fathers' parenting behaviors (warmth, behavioral control, psychological control) and parent-adolescent communication (open communication, problematic communication). Mothers and fathers reported their own internalizing symptoms.

Bereaved siblings reported more externalizing problems (

=.048) and bereaved mothers reported more internalizing symptoms relative to the comparison group (

=.015). Serial mud the impact on their parenting and communication. Targeting adjustment and parenting in bereaved mothers following a child's death may reduce externalizing problems in bereaved siblings. Research to evaluate family-centered interventions is needed.

The adoption of research-supported treatments is contingent upon multiple interactional levels, including provider level factors. Provider-level factors have been shown to be critical to uptake. The purpose of this study is to examine the relationship between sociodemographic factors, attitudes, and perceived barriers/facilitators to implementation through a comparative approach involving practitioners trained to facilitate a multiple family group intervention for children with disruptive behavior.

Participants included 91 practitioners who participated in an intervention study regarding barriers to adopting an evidence-based practice. Demographic characteristics were collected via a socio-demographic questionnaire. Barriers and facilitators were assessed via open-ended questions as well as a scale, developed by the authors and guided by the Consolidated Framework for Implementation Research that explored provider views regarding the intervention, the systemic and organizational context, experience faciliuitment rates and promoting adequate training and supervision is needed.

Autism spectrum disorder (ASD) is characterized by impairments in behavior, social communication, and interaction. There is little data on ASD from sub-Saharan Africa (SSA) describing clinical characteristics in large cohorts of patients. Preliminary studies report a high male sex ratio, excess of nonverbal cases, possible infectious etiologies, and comorbidities e.g. epilepsy.

To describe the clinical characteristics of children diagnosed with ASD in an African context.

A retrospective medical chart review identified 116 children diagnosed with ASD according to DSM-5 criteria at a pediatric neurology clinic in Nairobi, Kenya.

The male to female ratio was 4.31. The median age at presentation was 3 years with speech delay as the most common reason for presentation. Expressive language delay was observed in 90% of the population. Sixty percent who obtained imaging had normal MRI brain findings. Only 44% and 34% of children had access to speech therapy and occupational therapy respectively. Epilepsy and ADHD were the most prevalent comorbidities.

An early median age at presentation and preponderance of male gender is observed. Access to speech therapy and other interventions was low. A prospective study would help determine outcomes for similar children following appropriate interventions.

An early median age at presentation and preponderance of male gender is observed. Access to speech therapy and other interventions was low. A prospective study would help determine outcomes for similar children following appropriate interventions.A 65-year-old male patient with a history of heart valve replacement surgery after aortic valve stenosis and a family history of heart disease presented to the emergency room with complaints of headache, fever, back pain, and general malaise. Multiple blood samples during the patient's hospitalization cultured showed Rothia dentocariosa. The patient was started on daily intravenous ceftriaxone and vancomycin. In the following weeks, the patient's condition deteriorated with additional symptoms, persistent inflammatory markers, and elevated fever consistent with R. dentocariosa infection. The patient's clinical progression led to a cerebrovascular accident that was resolved with thrombectomy. Full symptomatic relief occurred after a valve replacement. R. dentocariosa, a common mouth flora, is not commonly pathogenic. This case is of particular importance as severe complications involving this bacterium are rare. There is an extreme paucity of cases involving deadly complications of R. dentocariosa, and there is no general consensus involving standard treatment regimen for this bacterium. We believe that this paper adds to clinical knowledge surrounding R. dentocariosa.Enterococcus durans is an extremely rare cause of infective endocarditis. We have reported the first case where a 56-year-old female presented with late prosthetic valve infective endocarditis on a mechanical mitral valve. Medical management failed and eventually lead to the demise of the patient.The incidence of ocular syphilis is increasing in the developing world even in the era of effective human immunodeficiency virus (HIV) treatment, as there is a potential increase of high-risk sexual behavior. Ocular involvement in the form of uveitis is seen in all stages of syphilis. Diagnosis begins with ophthalmologic examination, but requires serologic testing for confirmation. Ocular syphilis presents with unusual presentations or mimics other diseases and is identified by serological screening. It is curable with a relatively short course of antibiotic treatment, making its recognition a priority. All ophthalmic manifestations of syphilis should be treated with a Centers for Disease Control and Prevention-approved neurosyphilis regimen. In this report, we present a case of necrotizing retinitis with no response to antiviral treatment. On subsequent serological testing it was proved as syphilis in a HIV-positive patient who responded well to intravenous antibiotics with rapid visual recovery. Hence, awareness of this disease will promote early diagnosis and treatment.

Tuberculosis (TB) in India is a leading public health problem plagued by social determinants such as stigma and discrimination, which may affect treatment seeking, adherence, and possibly treatment outcome. This study was conducted to elicit the perceived discrimination, its determinants, as well as to determine whether perceived discrimination is predicting treatment outcome among TB patients registered in an Urban Health District, Kolkata City, India.

An institutionbased follow-up study was conducted where all the TB patients registered within the 1

4 months of data collection were followed up for their current course of treatment.

Perceived discrimination was assessed at treatment initiation, after intensive period and after continuation phase using a predesigned and pretested questionnaire.

Multivariable logistic regression analyses were performed to identify the determinants of perceived discrimination as well as the treatment outcome.

Perceived discrimination by family members, neighbors, and colleagues was reported by 9.4%, 36.5%, and 34.2% participants, respectively, overall discrimination being 37.9%. Multivariable analysis revealed that discrimination was significantly more among patients with older age group, females, and from joint families. Perceived discriminated was found to be significantly predicting unfavorable treatment outcome even after adjustment with background and treatment-related variables.

Sensitization programs should incorporate measures to address stigma and discrimination and more emphasis needs to be placed on women and elderly patients.

Sensitization programs should incorporate measures to address stigma and discrimination and more emphasis needs to be placed on women and elderly patients.

MBL containing genes have been reported in all GNBs including

spp since 1990s which are worrisome as they are transmitted by mobile genetic elements. Thus, early detection of MBL encoding organisms is necessary. The current study was designed to identify the most sensitive cost-effective test which could be used as a screening test for detection of cabapenamase producing

isolates.

All consecutive strains of

spp isolated from various clinical samples were included. All isolates found resistant to any of the carbapenems were tested for MBL production using MHT (on MacConkey Agar and Mueller Hinton Agar), Etest (using Imipenem/Meropenem-EDTA) and Combined Disc Test (using EDTA and 2 MPA as inhibitors and Ceftazidime/Imipenem/Meropenem as substrate discs). PCR was performed for representative strains for IMP, VIM, KPC, OXA and NDM-1 gene.

Total of 154 non-duplicate strains of

spp were isolated and identified, of which, 134 (88%) and 126 (82%) were resistant to meropenem and imipenem respectively. All 134 meropenem resistant strains were tested for MBL production and PCR was performed on 100 strains. 3(3%), 5(5%), 7(7%), 26(26%), and 51(51%) strains had IMP gene, VIM gene, KPC gene, OXA gene and NDM-1 gene. MHT on MAC had better performance than on MHA and dilution to 0.05 McFarland was not required.

MHT on MAC had best sensitivity when compared with gold standard PCR and was also cost effective. With ROC curve, we found that 2MPA was not a good MBL inhibitor when compared with EDTA..

MHT on MAC had best sensitivity when compared with gold standard PCR and was also cost effective. With ROC curve, we found that 2MPA was not a good MBL inhibitor when compared with EDTA..

Visceral leishmaniasis (VL) is one of the common infections in Sudan and can be associated with an increase in morbidity and mortality. The aim of this study was to assess the risk factors associated with mortality and morbidity with VL.

This is a cross-sectional hospital-based study that recruited 150 patients with VL from two centers in Khartoum. Secondary data were extracted from the patient records, and data were analyzed using SPSS version 24.0.

The study included 2.5% of infants, 39.4% children, and 58% of adults. Male represents 77.3% of the cohort, and total mortality was 16%. Among the death reported 12.5% in infants, 16.7% were children, and 70.8% were in adults. Laboratory parameters significantly associated with mortality in univariate analysis were low white cell count, low platelets, high creatinine, and high liver enzymes. While risk factors such as infant, male, acquired infection from Eastern Sudan or White Nile, weight loss, morbid diseases, and concomitant bacterial infections were alance survival. Patients with Leishmania are vulnerable; therefore, regular routine blood tests are an essential part of management to manage complications such as renal, hepatic failure, or severe anemia.

Microorganisms are known to be involved in the formation of biofilm. These biofilms are often seen in chronic wound infections, surgical site infections, implants etc., These are capable of causing recalcitrant infections and most of them are also known to possess high antibiotic resistance.

This study was conducted to detect the biofilm formation in bacterial isolates from chronic wound infections.

In the present study, ninety two isolates from chronic wound infections were identified by MALDI-TOF-MS (bioMerieux) and VITEK-2-MS (bioMerieux). Selleck GSK-3 inhibitor These isolates were further screened for biofilm formation by three methods i. e., Tissue Culture Plate method (TCP), Tube Method (TM) and Congo Red Agar (CRA) method. Impact of biofilm production was correlated with the antibiotic resistant pattern.

Statistical analysis was done for all three methods considering TCP as Gold Standard and parameters like senitivity and specificity of TM i.e. 47.2 and 100% respectively.

Out of 92 isolates, biofilm formation was seen in 72 isolates (78.