Antimicrobial resistance (AMR) is a global concern, especially in low- and middle-income countries, threatening food production, healthcare, and life expectancy. Antimicrobial stewardship (AMS) programs can optimize antibiotic use, improve patient outcomes, lower AMR, and save healthcare costs. This observational-retrospective study in Dhi Qar Governorate aimed to assess antimicrobial prescribing patterns in Al-Nasiriya public hospitals. Dhi Qar Health Directorate comprises ten hospitals, and only one hospital was excluded from the study. The study used data from antibiotic stewardship committees, including antibiogram, antibiotic, and meropenem surveys, hospital pharmacies’ medical files, and the directorate statistics from 1/1/2023 to 1/10/2023. The number of patients undergoing antibiotic screening was 6090. Most patients (43.34%) were in the 18–49 years age range. Most cases of antibiotics' clinical indication were surgical procedures (41.82%), with cesarean sections being the most common (16.15%), followed by medical treatment (37.25%), with respiratory conditions (21.34%) being the most common. Most patients (99.72%) received empirical rather than targeted treatment, parenteral rather than oral treatment (98.93% were given parenteral antibiotics); more than half of patients (52.84%) were prescribed a combination of two or more antibiotics. Most cases (95.43%) in antibiotic screening were continued on the same dose without reviewing the antibiotic prescription after 48–72 hours. The treatment resulted in 87.75% healing, 53.57% discharge with antibiotic discontinuation, and a 1.21% death rate among patients. Metronidazole, ceftriaxone, meropenem, amoxicillin, and cefotaxime were the most frequently prescribed antibiotics. The data from hospital pharmacies’ medical files showed the consumption of 14 types of antibiotics within the WHO's Watch group and 18 within the Access group. The most antibiogram-isolated bacteria were E. coli (19.06%), Staphylococcus non-aureus spp. (18.74%), Staphylococcus aureus (11.26%), Klebsiella pneumonia (10.15%), and Pseudomonas aeruginosa (7.88%). The antibiogram showed resistance to many antibiotics, and there was a significant difference in resistance distribution among the Access, Watch, and Reserve groups (P value = 0.024). Antibiotic practice showed empirical treatment with broad-spectrum antibiotics (most of which are in the WHO Watch group), limited culture and sensitivity testing, and limited antibiogram use, making monitoring antibiotic resistance hard.
Background: Polymethylmethacrylate (PMMA) has relatively unsatisfactory mechanical properties such as low flexural strength and impact strength also dimensional instability. Material and method: Zirconium silicate nanoparticles were coated with a layer of trimethoxysilylpropylmethacrylate (TMSPM) before sonication in monomer (MMA) with the percentages 1% and 1.5% by weight then mixed with powder using conventional procedure, (150) samples were prepared and divided into three groups, each group consisted of (50) samples, the first group prepared from PMMA without addition (control), another group with the addition of 1% wt Zrsio4 nanoparticles (experimental) and the third one with 1.5% wt Zrsio4 nanoparticles (experimental). Each group
... Show MoreThe synthesis of ligands with N2S2 donor sets that include imine, an amide, thioether, thiolate moieties and their metal complexes were achieved. The new Schiff-base ligands; N-(2-((2,4-diphenyl-3-azabicyclo[3.3.1]nonan-9-ylidene)amino)ethyl)-2-((2-mercaptoethyl)thio)-acetamide (H2L1) and N-(2-((2,4-di-p-tolyl-3-azabicyclo[3.3.1]nonan-9-ylidene)amino)ethyl)-2-((2-mercaptoethyl)thio) acetamide (H2L2) were obtained from the reaction of amine precursors with 1,4-dithian-2-one in the presence of triethylamine as a base in the CHCl3 medium. Complexes of the general formula K2<
BACKGROUND: The degree of the development of coronary collaterals is long considered an alternate–that is, a collateral–source of blood supply to an area of the myocardium threatened with vascular ischemia or insufficiency. Hence, the coronary collaterals are beneficial but can also promote harmful (adverse) effects. For instance, the coronary steal effect during the myocardial hyperemia phase and that of restenosis following coronary angioplasty.
Estimation of the unknown parameters in 2-D sinusoidal signal model can be considered as important and difficult problem. Due to the difficulty to find estimate of all the parameters of this type of models at the same time, we propose sequential non-liner least squares method and sequential robust M method after their development through the use of sequential approach in the estimate suggested by Prasad et al to estimate unknown frequencies and amplitudes for the 2-D sinusoidal compounds but depending on Downhill Simplex Algorithm in solving non-linear equations for the purpose of obtaining non-linear parameters estimation which represents frequencies and then use of least squares formula to estimate
... Show MoreMixture experiments are response variables based on the proportions of component for this mixture. In our research we will compare the scheffʼe model with the kronecker model for the mixture experiments, especially when the experimental area is restricted.
Because of the experience of the mixture of high correlation problem and the problem of multicollinearity between the explanatory variables, which has an effect on the calculation of the Fisher information matrix of the regression model.
to estimate the parameters of the mixture model, we used the (generalized inverse ) And the Stepwise Regression procedure
... Show MoreThe biggest problem of structural materials for fusion reactor is the damage caused by the fusion product neutrons to the structural material. If this problem is overcomed, an important milestone will be left behind in fusion energy. One of the important problems of the structural material is that nuclei forming the structural material interacting with fusion neutrons are transmuted to stable or radioactive nuclei via (n, x) (x; alpha, proton, gamma etc.) reactions. In particular, the concentration of helium gas in the structural material increases through deuteron- tritium (D-T) and (n, α) reactions, and this increase significantly changes the microstructure and the properties of the structural materials. T
... Show MoreTraumatic radial nerve injury in humeral shaft fracture is the most common traumatic nerve injury in long-bone fracture, with overall prevalence 2-18%, ranging from traction to complete transection. Spontaneous recovery may reach 88%. The aim of the study is to assess the sensitivity & specificity of the ultrasound to detect the radial nerve injury and to see if this can be used as a diagnostic test. This is a prospective study on 17 adult patients with a closed fracture of the humeral shaft, dividing into two groups, the first group of 7 patients had signs and symptoms of radial nerve palsy at presentation and the second group of 10 patients had intact radial nerve function was considered as a control group. All these patients had at leas
... Show MoreThe simulation have been made for 3D flow structure and heat transfer with and without
longitudinal riblet upstream of leading edge vane endwall junction of first stage nozzle guide vane .The research explores concept of weakening the secondary flows and reducing their harmful effects.Numerical investigation involved examination of the secondary flows ,velocity and heat transfer rates by solving the governing equations (continuity, Navier -stokes and energy equations ) using the known package FLUENT version (12.1).The governing equations were solved for three dimentional, turbulent flowe, incompressible with an appropriate turbulent model (k-ω,SST) .The numerical solution was carried out for 25 mode
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