Werner syndrome is considered inherited premature ageing and genomic instability syndrome. It is an autosomal recessive disorder in which aging process is accelerated starting after puberty. It is also termed as Progeria adultorum. The hallmark features are short stature, senile facies, scleroderma like skin (dry atrophic skin, mottled darkness, telangiectasia, sclerodactyly, and gangrene), cataract, hypogonadism, contractures of skin over joint, premature atherosclerosis, loss of subcutaneous fat and ulcers over feet and leg. Treatment of painful ulcers is difficult with increased risk of malignancy (fibro sarcoma in 10% of patients). Death is usually occurring in the fourth to sixth decade due to myocardial infarction or malignancy. We reported 2 brothers of Pangeria of positive consanguinity parents the older is 40 years old, short stature, senile facies with bilateral hip joint replacement, chronic leg ulcer, bilateral cataract extraction and the younger is 35 years old, short stature, senile facies, infertile, previous cataract extraction with bone deformity. The later presented to us in outpatient clinic, Internal Medicine department, Tanta university Hospital, Egypt for preoperative assessment for cataract operation. We admit the patient to investigate him and to confirm our provisional diagnosis as regard Werner syndrome. As no definite treatment for this disorder and death usually occurs in the fourth to sixth decade, early diagnosis and follow up is beneficial and screening for malignancies and associated diseases should be performed regularly.

To improve clinical decision-making about Carbapenem-resistant Gram-negative bacteria (CR-GNB) infections and halt the spread of resistant microbes, quicker and less expensive diagnostic techniques are required. Thus, the purpose of this study was to thoroughly evaluate the diagnostic efficiency (sensitivity, specificity, and concordance) of direct-from-specimen multiplex lateral flow immunoassay (LFIA) across diverse raw clinical specimens and pathogen types from critically sick patients. A total of 300 non-duplicate samples were tested to detect CR-GNB. Five major Carbapenemase genes were detected directly from the specimen using carbapenem-resistant K.N.I.V.O. detection K-Set and from culture using culture-enhanced multiplex PCR. Turnaround time (TAT) of each method was calculated. The direct LFIA revealed 100% specificity for NDM, KPC, and IMP enzymes in all tested clinical matrices (blood, urine, and respiratory samples). The study demonstrated 100% sensitivity and specificity with perfect categorical agreement (κ = 1.000) for the blaKPC in the Klebsiella pneumoniae and for blaOXA-48 and blaIMP in the Acinetobacter baumannii; however, sensitivity of blaVIM was significantly diminished across all isolates and samples. TAT decreased significantly (p < 0.001) from 30 to 70 h to about 50 min. The tested direct LFIA facilitates the prompt enhancement of lifesaving tailored antibiotic treatment for severe illnesses.