European Journal of Molecular & Clinical Medicine

The aim of this study was to analysis of mesh related infections in a tertiary care centre.
Methods: A retrospective descriptive study was conducted in the department of Surgery for one year and 50 patients were included in the study.
Results: Mesh infection was more common in males. Among 50 patients, 40 were males and 10 female patients. Majority of the patients were in the age group 40-50 (40%) followed by 50-60 age group 30%. 30% cases were repaired with open repair and rest of the patients was repaired with lap repair. In our study, mesh infection was more common in obese patients with a mean BMI of 32.70+/-1.78kg/m2. (Range 30.40-34.10). 40% patients had co-morbidities. The antibiotic protocol was followed in 48 cases out of 50. Antibiotic has used according to the protocol of our hospital; it was followed in 48 patients in the first surgery i.e., hernia repair surgery. Parenteral cephalosporin was used in 48 patients and amoxicillin-clavulanic acid in 2 patients. Antibiotic has repeated if the procedure was beyond 2 hours. After postoperative day 2, patients were switched over to oral antibiotics for three days. Likewise, during the second admission, i.e., when the patient was admitted with mesh infection, 48 patients were given cephalosporin and 2 patients were given Piperacillin tazobactam.
Conclusion: In our study incidence was more common after laparoscopic surgeries because there was a lapse in the sterilization process of the laparoscopic instruments, which was rectified with timely culture sensitivity tests and stringent sterilization process.

Presence of hypoplastic teeth on erupted permanent dentition in young children poses a psychological trauma to patient as well as to parents also where management of these defects in non-invasive manner is a real challenge to dentist also as per reported clinical picture. In this case series we have shown four clinical cases we have opted conservative approach for management of hypoplastic defects in young permanent teeth based on present clinical picture of patient’s chief complaint aesthetically and functionally in minimally invasive manner

Cleaning and shaping of the root canal space is the primary objective of endodontic therapy. Its purpose is to prepare the canal space in order to improve disinfection with the use of irrigants as part of chemo mechanical preparation. Infiltration and subsequent infection of the root canal system by microorganisms and their byproducts is the primary etiology of endodontic pathosis. Chemo-mechanical preparation aims to remove microorganisms, remaining pulp tissue and dentin debris from the root canal system.
The main objective of shaping is to maintain or develop a continuously tapering funnel from the canal orifice to the apex; however the complex canal anatomy causes instrumentation challenges, which may prevent adequate disinfection of the root canal system, or cause procedural errors such as instrument separation, transportation, ledges or perforations. The present study was set out to determine canal centering ability, transportation and curvature using 5^th generation NiTi rotary systems as mentioned above.

Background: Surgical removal of the third molar is one of the most common surgical procedures performed as a day case or as an inpatient. The present study was conducted to assess frequency estimate and assessment of risk factors in third molar removal.
Materials & Methods: 78 patients undergoing third molar extraction of both genders were recruited. Level of impaction (soft tissue, partial bony, or total bony), angulation, and the presence or absence of an inflammatory condition associated with the impaction, type of anesthesia (local anesthesia alone or local anesthesia and sedation), type of flap (envelop or triangular), bone removal and postoperative complications were recorded.
Results: Out of 78 patients, males were 42 and females were 36. Alveolar osteitis was present in 5, trismus in 8, infection in 4 and paresthesia LN in 7 cases. The difference was significant (P< 0.05). Maximum cases of alveolar osteitis had mesio- angular impaction (2), anesthesia used was LA+ sedation (3), triangular flap (4) and partial bony (3) level of impaction. Maximum cases of trismus had mesio- angular impaction (4), anesthesia used was LA+ sedation (5), triangular flap (5) and partial bony (5) level of impaction. Maximum cases of infection had mesio- angular impaction (4), anesthesia used was LA+ sedation (5), triangular flap (5) and partial bony (5) level of impaction. Maximum cases of paresthesia LN had mesio- angular impaction (4), anesthesia used was LA+ sedation (5), triangular flap (4) and partial bony (4) level of impaction.
Conclusion: Common complication found were alveolar osteitis, trismus, infection and paresthesia LN. Most commonly mesio- angular impaction, LA+sedation, triangular flap and partial bony level of impaction was the leading cause.

Background: The assessment of procalcitonin not only provides valuable information about the diagnosis but is also useful in the selection of the corresponding antibiotics for the management of sepsis. The studies related to this procalcitonin role are comparatively sparse.
Objective: The present study was undertaken to observe the role of procalcitonin in the management of severe surgical patients with sepsis.
Materials and methods: A total of 50 patients diagnosed with sepsis and aged more than 18 years including both males and females were part of the study after obtaining the written, voluntary informed consent. Unwilling participants were excluded from the study. Patients with any severe complications were also excluded from the study.
Results: Results were presented in Tables no 1 and 2. Table no 1 presents the gender distribution of the participants. The majority of the participants were males with 56% and females were 44%. Table no 2 presents the levels of procalcitonin levels in the participants. The majority of the participants have excessive levels of procalcitonin levels. That is procalcitonin was more than 10ng/ml in 40 patients which means nearly 80 percent of the patients have excessive levels of procalcitonin. This will testify to the importance of procalcitonin in the diagnosis of sepsis.
Conclusion: Significantly higher levels of procalcitonin levels were observed in the patients with sepsis. The study results testify to the diagnostic value of the procalcitonin. The study recommends further detailed studies in this area to support the procalcitonin in the diagnosis of sepsis.

assess perceived risk by EPPM(Extended Parallel Processing Model) and the risk of COVID-19 infectionamong general population.
Methods: Cross sectional study was conducted among 185 general population ofChitradurga district. Questionnaire had three parts, 1. Socio-demographic data along with habits and co-morbidities. 2. Risk perception questions (29) with efficacy, defensive response and perceived threats. 3. A predesigned semi-structured questionnaire (24 questions) regarding their attitudes and practices towards COVID 19. Based on which their risk was assessed depending on score.. Chi-square, ANOVA, t-test and binary logistic regression was applied to find significant association.
Results: Among 185 study participants, majority were elders (>60 years) 25.5%, 100 (54.05%) were males, 108 (58.37%) belonged to nuclear family. Perceived risk scores were almost same in all the categories. A total of 106 (57.3%) participants were engaging in danger control processes and 79(42.7%) in fear control processes. Among population, 32.08%, and 44.30% people were in high and medium risk of infection respectively. Everybody is in risk. 85.27% frequently washed hands with soap or sanitizer, 76.8% used mask regularly when they go out, 74.26% do not wash their dress once they come from outside, 70.37% do not wash their shoes, 54.64% use mass transport. Among socio-demographic variables education, type of family and travel history were significantly associated with risk of infection.
Conclusion: Perceived risk was equal in almost all classes. The attitude and practice towards COVID 19 during pandemic was not so impressive.

Background: The ideal operation for pilonidal sinus disease should be a simple one with low complication and low recurrence rates. This is achieved by flap techniques which flatten the natal cleft with an off-midline closure. The aim of the present study to determine the better procedure in treatment of pilonidal sinus disease, compare the efficiency and short-term results of conservative treatment, open excision, Karydakis flap and Rhomboid flap in treatment of pilonidal sinus disease. Patients and methods: A randomized controlled study included 56 patients with pilonidal sinus disease were admitted to General Surgery Department, Zagazig University Hospitals. The patients were allocated equally into: group (1) were treated with conservative method with medical treatment and drainage if needed; group (2) were operated by open technique; group (3) were operated by Limberg flap technique and group (4) were operated by Karydakis technique. Patients were subjected to full history and clinical examination, preoperative investigations and postoperative assessment. Results: The present study showed no significant difference regard age distribution as age was distributed as 30.71±5.73, 32.21±6.58, 32.57±6.47 and 32.42±8.2 respectively among groups. Conservative group was significantly shorter duration of symptoms than other groups with no significant difference. Operative time was significantly longer among Limberg group than Karydakis group and finally open group as it was significantly shorter than other group. Visual analog scale (VAS) was significantly higher among open cases. Healing and return work were significantly higher among open groupg compared to other groups. Recurrence was significantly associated with open and conservative groups while there was only one case in Limberg Group and no case in Karydakis Group. Bad and good satisfaction were significantly associated with open and conservative groups while excellent was significantly associated with Limberg Group & Karydakis Group. Conclusion: The four techniques are effective in treatment of pilonidal sinus while Conservative is preferred at early stage of the disease and flap techniques has better results and satisfaction than Open one. The Karydakis flap is prefered the Limberg flap for treating uncomplicated Sacrococcygeal pilonidal disease due to shorter operative and healing time with superior patient satisfaction.

COVID-19 is the disease supported by SARS-CoV-2 infection, which causes a severe form of pneumonia. Due to the pathophysiological characteristics of the COVID-19 the particular transmissibility of SARS-CoV-2, and the high globalization of our era, the epidemic emergency has spread rapidly all over the world. Human-to-human transmission seems to occur mainly through close contact with symptomatic people affected by COVID-19, and the main way of contagion is only through the inhalation of respiratory droplets, for example when patients talk, sneeze or cough.The dental practitioners are particularly exposed to a high risk of SARS-CoV-2 infection because they cannot always respect the interpersonal distance of more than a meter and are exposed to saliva, blood, and other body fluids during surgical procedures. Moreover, many dental surgeries can generate aerosol, and the risk of airborne infection is to be considered higher. The questionnaire was shared among students pursuing dentistry which contained a set of 10 questions . The questions were about duration , practice on PPE and how aware and protected the students are during treating the patients.88% of them agreed that the gloves they wear protect them from viral pathogens and 5% did not agree and 7% of them were not sure about it .90% of them were trained on personal protective equipment whereas 10% of them were not trained before.This study observed good awareness regarding the practice of using protective equipment during dental treatment among the respondents.

Background: Vaginal infection is acknowledged as a significant public health issue that affects women of reproductive age and results in a number of issues. The technique of contraception that is used increases the risk of genital infection. The most frequent cause of vaginal discharge in women of reproductive age is bacterial vaginosis. Although the typical vaginal flora differs from person to person, lactobacilli are often the dominant organism. There are other aerobic and anaerobic species in the bacterial flora. These are regarded as pathogenic in some cases. It is known that pelvic inflammatory illness, preterm premature rupture of the membranes (PROM), post-operative gynecologic infections, and abnormal Papanicolaou smear can all be indicators of bacterial vaginosis.

Primum non nocere is a principle proclaimed by Hippocrates and remains relevant throughout the history of medicine. Unfortunately, pharmacotherapy does not always correspond to it. Although modern oral antibacterial drugs generally have a favorable safety profile, there are still many side effects. Antibacterial, like all medicines, have side effects, some of the side effects can be serious and some are dire. The use of antibacterial drugs in all areas of medicine, often unreasonable indications for their use, free access for the potential consumer - all this leads to irrational use of drugs, starting from an early age. More than 50% of diseases are infectious in nature. Infectious drugs account for 20% of all drugs currently used in medicine. The misuse of antibiotics is fraught with the development of antimicrobial resistance in the pathogen.

In this work, we analyzed the frequency of violations of the vaginal microbiota and the development of infectious and inflammatory complications during post-placental intrauterine contraceptive administration during abdominal delivery. Currently, the incidence of infectious and inflammatory diseases in obstetrics does not tend to decrease. In the structure of infectious and inflammatory diseases, a significant place is occupied by postoperative purulent-septic complications – endometritis, suppuration of wounds on the uterus and anterior abdominal wall after cesarean section. One of the tasks solved in the course of this study was to identify the correlation between the state of the birth canal microbiota and the development of complications when using IUDs during cesarean section.

The outbreak of COVID-19 disease began in December 2019 in the city of Wuhan in China, also recognized as China's largest transport centre. The condition became epidemic during China's spring festival. The virus is quickly transported into several nations, including countries with low wages So far, 234073 have registered COVID-19 cases in the world with a total of 9840 fatalities. Cough, high fever, a sore throat, tiredness and respiratory trauma are the typical signs of COVID-19. The condition was shown to be moderate in most cases, others with pneumonia with multi-organ failure and acute ARDS. The Incubation Time for the infection has been observed to be 2-14 days, typically 4 days in maximum cases. India remains in stage 2 on local transmission in line with WHO Record 60. The WHO announced 60 that no population transmission has yet occurred in India that can be avoided by preventing mass meetings and proper citizens screens. Govt. Govt. There have been several initiatives by India to minimize the spread of COVID-19 in the region. The COVID-19 infection incidence in India appears to be poor in comparison to the country's population. This is attributable to swift government measures to quarantine and close down the boundaries of the accused population. The global economy is in great slowdown due to COVID-19 assault and would potentially cost roughly $1 trillion. This is attributable to swift government measures to quarantine and close down the boundaries of the accused population. By reducing H-H transmissions, the spread of COVID-19 infections may be minimized. Anti-CoV drug discovery is also required, and will replace the supporting therapies for infection control.

The incidence of multidrug-resistant organisms (MDROs) is found increasing in hospitals, in which this case causesan increaseinhealthcare-associated infections. Healthcare-associated infections (HAIs) or nosocomial infection is an infection obtained in a hospital after more than 72 hours of being admitted to the hospital. This infection transmission by multidrug-resistant organisms is caused by the health workers’ hand hygiene. One of the most effective prevention is to do proper hand hygiene, which results in breaking the chain of the multidrug-resistant organism incidence.Therefore, hand hygiene compliance may reduce healthcare-associated infection.This study aims to discoverthe relationship between hand hygiene andthe multidrug-resistant organism incidence. This study was a descriptive research conducted by utilizing surveillancedata of multidrug-resistant organisms in the intensive care unit (ICU) and the hospital ward in 2018, and the audit of WHO’s protocols for hand hygiene was collected by the infection prevention and control committee from January to December 2018. The result showed that the rate of hand hygiene compliance in 2018 at the ICU was 66% while at the hospital ward,on average,was about52%. There was a decrease in the multidrug-resistant organism incidencein 2018 compared to 2017; in the ICU, the highest percentage reduction was multidrug-resistant Acinetobacter baumannii (54.5 %), and the lowest was extended-spectrum beta-lactamase (5.5 %). Meanwhile, in the hospital ward, the highest percentage reduction was multidrug-resistant Acinetobacter baumanniiincidence (50%),and the lowest was extended-spectrum beta-lactamase (4%).Therefore, the trend patterns show aninverse correlation between hand hygiene compliance and multidrug-resistant organism incidence in the ICU and the hospital ward.

The facemask is a personal protective equipment which is used to prevent the droplet or aerosol spread. Due to the pandemic spread like SARS, COVID-19 the mask is recommended to be worn by all the people to prevent the infection. It is one of the non-pharmaceutical ways of prevention, it helps in controlling the spread but not in complete eradication of the disease.This is a widely used way of prevention, which is cheap, non-invasive and has capacity to reduce the mortality rate due to respiratory infection. The major problem associated with these equipment are, they are commonly misused and they go out of stock even before the health care sector receives these equipment. So proper selection of masks is required to prevent the infection and also to reduce the demand of masks in the health sector. The aim of this review is to understand the importance of masks and needs of the personal protective equipment during the onset of any pandemic conditions. A systematic search strategy was done and the articles were found using keywords. Literature was taken from databases like PubMed and Google Scholar. The articles which discussed face masks were included and other articles which had the different types, advantages and disadvantages were also included. The review summarises the needs and the urge to use a face mask at the onset of pandemic condition. Selection of proper mask is emphasised to reduce the demand of masks.

Aim: A research with the goal of determining the antibiotic susceptibility pattern of uropathogens responsible for catheter-associated urinary tract infections (CAUTI) in a tertiary care hospital. Materials and Methods: There were a total of 300 individuals that required catheterization. During her daily rounds, the infection control nurse gathered all of the pertinent information, such as the patient's name, age, sex, the date of their catheterization, and laboratory findings. The CAUTI diagnosis was carried out in accordance with the CDC criteria that were issued in 2009. Patients of both sexes who were more than 18 years old and who had been placed on a Foley's catheter for at least 48 hours were considered for inclusion in the research. This selection criteria were used to determine who would be included in the study. Results: Out of 300 catheterized patients, 20 developed CAUTI. The overall incidence was 6.67%. Male patients were more than the female patients for catheterization. Catheterization days ranged from 2 days to 12 days. The most common uropathogens were E. coli (40%) and Klebsiella pneumoniae (40%) followed by Pseudomonas aeruginosa (10%) and Acinetobacter species (10%) from the cases of CAUTI. Imipenem was the single best antibiotic for all pathogens except Pseudomonas aeruginosa where Amikacin was the drug of choice. The Acinetobacter species also showed very high resistance to all antibiotics except Imipenem. Conclusion: CAUTI continued to be a significant risk to the health of patients and a difficult obstacle for the staff working in infection control. The implementation of appropriate care packages and the provision of ongoing education to health care staff each play a significant part in the reduction of CAUTI rates, which in turn leads to a reduction in the morbidity of patients and the length of their stays in hospitals.

Background
Health care associated infections (HCAI) are one of the most serious and complex worldwide health problems. Commitment to standard precautions (SPs) and infection control (IC) measures are important to all healthcare providers (HCP) to prevent occupational exposure to hazardous materials. Healthcare workers (HCWs) are particularly more prone to blood-borne pathogens through contact with infected blood and body fluids during their work. It is based on the presumption that every person is infected or colonized with an organism that could be transmitted in the healthcare setting and thus health care workers need to apply infection control practices during the delivery of health care.Health care worker at risk of health associated infection (HAIs) due to their exposure to the patients during carrying out their duties. Health care workers in primary health care centers are the first to detect and to prevent the spread of infection. Standard precautions are regarded as an effective means for protecting health care worker, patients and community.
 Aim of the study: The study aimed to assess the level of Knowledge and practices of infection control standard among health care workers at the primary healthcare level in Makkah City.
Method:  A cross sectional study enrolled HCWs (doctors, nurses, lab workers) from 10 primary healthcare (PHC) centers in in Makkah, during the April to June, 2021, Our total participants were (200)
.Results:the knowledge regarding standard precautions of infection control study results show the majority of participant had average information were(55.0%) while weak knowledge were(21.0%) the data ranged from(5-18) by mean ±SD(12.15±3.11), also the Nationality is a significant relation between knowledge and Practices increase in the non-Saudi healthcare workers were mean+ SD respectively (12.980±2.606, 6.603±1.510), compared to the Saudis had adequate level of knowledge Practices where (T=-5.33, T=-6.152) and P-value=<0.001.
Conclusion: There was a gap between the actual and desired Knowledge and practices of Healthcare providers regarding IC. Continuing education programs are needed to improve their Knowledge and practices scores towards SPs and IC measures in order to reduce HCAI, inadequate knowledge particularly concerning the disposal of sharp instruments and hand hygiene were also detected. The studies highlighted the necessity of the provision of a comprehensive training program to ensure compliance with infection control measures by HCWs.
 

  Background
       The Kingdom of Saudi Arabia (KSA) annually hosts more than three million Muslim pilgrims from around 184 countries during the Hajj pilgrimage. Respiratory tract infection (RTI) is a major public health challenge during the Muslim pilgrimage to Makkah. It is necessary to take health precautions among these pilgrims the uptake of health preventive measures among Hajj pilgrims from Saudi Arabia, bacteremia, otitis media, and bacterial meningitis, in addition to a significant cause of sinusitis, osteomyelitis, septic arthritis, endocarditis, and peritonitis. Complications of each of these diagnoses are common. Pneumonia is one of the leading causes of hospitalization and intensive care unit among pilgrims in Saudi hospitals during Hajj. During the 1986 Hajj season, pneumonia was the second most common cause of hospitalization with the highest case fatality ratio among those aged over 50 years, therefore pneumococcal vaccination is recommended. Clinical symptoms, signs and physical examination findings alone cannot differentiate pneumonia disease from infections caused by other pathogens,to our knowledge there is no study that has explored the knowledge, attitude, and practices related to pneumococcal infection and vaccination among all Hajj pilgrims in KSA.
Aim of the study:To assessment of awareness and Attitude toward Prevention of Pneumococcal Infection and vaccination among Hajj and Umrah Pilgrims from Makkah in 2018
.Methods:Methods: Across sectional descriptive study conducted among pilgrims who resident in Makkah city during May 25, 2018 to 24 October 2018  Hajj 2018,  Our total Sample size of pilgrims participants were (500)
Results: the majority of participants (67.0%) have a weak knowledge while Range (1-21) Mean± SD (8.155±3.011). While more than half of them (61.0%) have a positive attitude about the disease, while Range (0-8) Mean± SD (3.944±1.098
)Conclusion:Before Hajj doctors must teach and inform all the participants about how to deal with any infectious disease, particularly pneumonia.Significant opportunities for improving Knowledge and awareness among Hajj pilgrims about the importance of using preventive health measures. Moreover, emphasizes the need for better communication between official health authorities in Saudi Arabia and all Hajj pilgrims regarding Hajj health information.