Publications by authors named "Mohamed Osman"

180 Publications

Ameliorative effects of astaxanthin on brain tissues of alzheimer's disease-like model: cross talk between neuronal-specific microRNA-124 and related pathways.

Mol Cell Biochem 2021 Feb 11. Epub 2021 Feb 11.

Biochemistry Department, Medical Research Institute, Alexandria University, 165 El-Horreya Avenue, EL-Hadara, POB: 21561, Alexandria, Egypt.

Alzheimer's disease (AD) is a chronic, progressive, multifactorial, and the most common neurodegenerative disease which causes dementia and mental deterioration in the elderly. The available treatments for AD are not disease-modifying drugs and only provide symptomatic relief. Astaxanthin (ATX), a second-generation antioxidant, is a dark red carotenoid and exhibits the highest antioxidant capacity, anti-inflammatory, neuroprotective, and antiapoptotic effects. In this study, we investigated the therapeutic effect of different doses of ATX on the cerebral cortex and hippocampus of AD-like rats. The AD-like model was induced in rats using hydrated aluminum chloride (AlCl.6HO) solution that was given orally at a dose of 75 mg/kg daily for 6 weeks. Morris water maze (MWM) behavioral test was performed to confirm the cognitive dysfunction then AD-like rats were orally treated with different doses of ATX (5, 10, and 15 mg/kg) dissolved in dimethyl sulfoxide (DMSO) for six weeks. The results indicated that ATX significantly and dose-dependently improved the performance of AD-like rats treated with ATX during MWM and suppress the accumulation of amyloid β and malondialdehyde. Also, significantly inhibit acetylcholinesterase and monoamine oxidase activities and the expression of β-site amyloid precursor protein cleaving enzyme 1 (BACE 1). ATX also significantly elevated the content of acetylcholine, serotonin, and nuclear factor erythroid-2-related factor 2 (Nrf2) and miRNA-124 expression. The effect of ATX treatment was confirmed by histopathological observations using H&E stain and morphometric tissue analysis. From this study, we concluded that ATX may be a promising therapeutic agent for AD through targeting different pathogenic pathways.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11010-021-04079-4DOI Listing
February 2021

Stroke etiologies in patients with COVID-19: the SVIN COVID-19 multinational registry.

BMC Neurol 2021 Jan 30;21(1):43. Epub 2021 Jan 30.

Department of Neurology, Hospital Clínic, Barcelona, Spain.

Background And Purpose: Coronavirus disease 2019 (COVID-19) is associated with a small but clinically significant risk of stroke, the cause of which is frequently cryptogenic. In a large multinational cohort of consecutive COVID-19 patients with stroke, we evaluated clinical predictors of cryptogenic stroke, short-term functional outcomes and in-hospital mortality among patients according to stroke etiology.

Methods: We explored clinical characteristics and short-term outcomes of consecutively evaluated patients 18 years of age or older with acute ischemic stroke (AIS) and laboratory-confirmed COVID-19 from 31 hospitals in 4 countries (3/1/20-6/16/20).

Results: Of the 14.483 laboratory-confirmed patients with COVID-19, 156 (1.1%) were diagnosed with AIS. Sixty-one (39.4%) were female, 84 (67.2%) white, and 88 (61.5%) were between 60 and 79 years of age. The most frequently reported etiology of AIS was cryptogenic (55/129, 42.6%), which was associated with significantly higher white blood cell count, c-reactive protein, and D-dimer levels than non-cryptogenic AIS patients (p
Conclusions: Our findings suggest that cryptogenic stroke among COVID-19 patients carries a significant risk of early mortality.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12883-021-02075-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7846488PMC
January 2021

The Role of Diffusion-Weighted MRI and Apparent Diffusion Coefficient in Assessment of Diabetic Kidney Disease: Preliminary Experience Study.

Int J Nephrol Renovasc Dis 2021 11;14:1-10. Epub 2021 Jan 11.

Internal Medicine Department, Faculty of Medicine, Minia University, El Minia, Egypt.

Background: Diabetic kidney disease is the most common cause of ESRD. There is poor correlation between the degree of renal fibrosis and current screening markers. A noninvasive imaging technique is needed to assess the degree of structural changes in the kidney. The aim of this study was to assess the role of apparent diffusion coefficient (ADC) in the diagnosis of diabetic kidney disease. Forty adult diabetic patients with chronic kidney disease as well as 20 age- and sex-matched adult healthy controls were recruited from Nephrology Department of our University Hospital. All patients underwent renal MR-DWI and ADC mapping on a 1.5-T scanner (Philips Achieva) using phased array body coil.

Results: Among the studied 40 diabetic patients, five groups of patients were resulted 8 patients for each and the ADC values were inversely correlated with advancement in renal parenchymal affection, ie, in late stages of the disease the ADC values were lower than in early stages. The mean ADC values of renal parenchyma in patients with diabetic kidney disease were considerably lower than that of healthy controls with normal renal function (2.1±0.3x10 mm/s vs 2.4±0.1x10 mm/s with <0.001).

Conclusion: ADC value is a possible noninvasive technique in evaluating the stage of renal dysfunction with assessment of disease progression.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/IJNRD.S254022DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7810750PMC
January 2021

Workforce capacity for the care of patients with kidney failure across world countries and regions.

BMJ Glob Health 2021 Jan;6(1)

Medicine, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada

Introduction: An effective workforce is essential for optimal care of all forms of chronic diseases. The objective of this study was to assess workforce capacity for kidney failure (KF) care across world countries and regions.

Methods: Data were collected from published online sources and a survey was administered online to key stakeholders. All country-level data were analysed by International Society of Nephrology region and World Bank income classification.

Results: The general healthcare workforce varies by income level: high-income countries have more healthcare workers per 10 000 population (physicians: 30.3; nursing personnel: 79.2; pharmacists: 7.2; surgeons: 3.5) than low-income countries (physicians: 0.9; nursing personnel: 5.0; pharmacists: 0.1; surgeons: 0.03). A total of 160 countries responded to survey questions pertaining to the workforce for the management of patients with KF. The physicians primarily responsible for providing care to patients with KF are nephrologists in 92% of countries. Global nephrologist density is 10.0 per million population (pmp) and nephrology trainee density is 1.4 pmp. High-income countries reported the highest densities of nephrologists and nephrology trainees (23.2 pmp and 3.8 pmp, respectively), whereas low-income countries reported the lowest densities (0.2 pmp and 0.1 pmp, respectively). Low-income countries were most likely to report shortages of all types of healthcare providers, including nephrologists, surgeons, radiologists and nurses.

Conclusions: Results from this global survey demonstrate critical shortages in workforce capacity to care for patients with KF across world countries and regions. National and international policies will be required to build a workforce capacity that can effectively address the growing burden of KF and deliver optimal care.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjgh-2020-004014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7816926PMC
January 2021

COVID-19 patient with coronary thrombosis supported with ECMO and Impella 5.0 ventricular assist device: a case report.

Eur Heart J Case Rep 2020 Dec 20;4(6):1-6. Epub 2020 Nov 20.

Royal Papworth Hospital, Cambridge CB2 0AY, UK.

Background: COVID-19 can present with cardiovascular complications.

Case Summary: We present a case report of a 43-year-old previously fit patient who suffered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with thrombosis of the coronary arteries causing acute myocardial infarction. These were treated with coronary stenting during which the patient suffered cardiac arrest. He was supported with automated chest compressions followed by peripheral veno-arterial extracorporeal membrane oxygenation (VA ECMO). No immediate recovery of the myocardial function was observed and, after insufficient venting of the left ventricle was diagnosed, an Impella 5 pump was implanted. The cardiovascular function recovered sufficiently and ECMO was explanted and inotropic infusions discontinued. Due to SARS-CoV-2 pulmonary infection, hypoxia became resistant to conventional mechanical ventilation and the patient was nursed prone overnight. After initial recovery of respiratory function, the patient received a tracheostomy and was allowed to wake up. Following a short period of agitation his neurological function recovered completely. During the third week of recovery, progressive multisystem dysfunction, possibly related to COVID-19, developed into multiorgan failure, and the patient died.

Discussion: We believe that this is the first case report of coronary thrombosis related to COVID-19. Despite the negative outcome in this patient, we suggest that complex patients may in the future benefit from advanced cardiovascular support, and may even be nursed safely in the prone position with Impella devices.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/ehjcr/ytaa342DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7717226PMC
December 2020

Zinc Oxide Nanoparticles Prevents Multidrug Resistant Induced Footpad Dermatitis in Broilers.

Avian Pathol 2021 Jan 11:1-55. Epub 2021 Jan 11.

Department Animal Hygiene, Faculty of Veterinary medicine, New Valley University 72511, Egypt.

The current experiment was designed to evaluate the effects of dietary supplementations of zinc oxide nanoparticles (ZONPs) on some behavioural, performance, welfare and histopathological changes in broilers exposed to multidrug resistant (MRSA)-induced footpad dermatitis(FPD). Eighty-four males Indian River (IR) broilers were randomly allotted to six different dietary treatments as follows C-ve, C+ve, 10, 20, 30 and 40 ppm ZONPs from 7- 49ds of age. At day 28, broilers (n = 70) were subcutaneously injected 0.5mL of saline containing 5.3 × 10 cfu/ mL of (MRSA) in each metatarsal foot pad. Control (non-infected) broilers were given 0.5 mL of saline (n = 14). Results clarified that non-infected birds and ZONPs fed birds had significantly higher standing and feeding activities and lower resting activities in comparison with the infected group. Also, the infected group had significantly lower body weight gain (BWG) and higher feed conversion ratio (FCR) than the non-infected group. In addition, the non-infected birds and ZONPs groups had significantly lower object crossing and tonic immobility times (TI) and gait scores (GS) in comparison with the group. Only ZONPs 30, 40 ppm and non-infected groups had significantly higher latency to lie time (LLT) and lower serum cortisol level in comparison with the group. Moreover, there were significant changes in the gross lesion score and histopathological lesion between the different groups. In conclusion, the dietary supplementation of ZONPs can reduce induced negative effects of FPD in broilers.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/03079457.2021.1875123DOI Listing
January 2021

A Systematic Review of Complications Associated With Percutaneous Native Kidney Biopsies in Adults in Low- and Middle-Income Countries.

Kidney Int Rep 2021 Jan 3;6(1):78-90. Epub 2020 Nov 3.

Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa.

Introduction: Kidney biopsy is an important tool for making diagnoses and for assessing the drug treatment requirements and disease prognosis in the management of kidney diseases. There are variations in the rate of complications associated with kidney biopsies across countries, and this depends on various clinical and technical factors. The aim of this study is to report on complications associated with kidney biopsy performed in low- and middle-income countries.

Methods: Two reviewers searched tudies in MEDLINE, Embase, Cochrane Reviews, and African Journals Online. A random effects meta-analysis method was used to pool estimates of complications.

Results: We identified 39 studies reporting on 19,500 kidney biopsies with overall complications (major + minor) rate of 14.9% (95% confidence interval = 11.4%-18.7%). Fewer complications were reported in biopsies performed with real-time ultrasound scans compared to those pre-marked using ultrasound or blind procedures (12.4% vs. 14.9% vs. 24.5%;  = 0.037), respectively. Complications, albeit lower for procedures performed with automated needles (13.3%), were not significantly different from those performed with nonautomated needles (17.3%;  = 0.588). Major complications included macroscopic hematuria (1.48%), nephrectomy (0.04%), blood loss requiring red cell transfusion (0.24%), angiographic intervention (0.22%), and death (0.01%).

Conclusion: Complications associated with kidney biopsy in low- and middle-income countries are low, are comparable to those in other settings, and occur more sparingly when real-time ultrasound techniques or automated kidney biopsy needles are used. This suggests the need to expand the use of this procedure to improve diagnosis of kidney pathologies and choice of therapy when indicated.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ekir.2020.10.019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7783578PMC
January 2021

Hereditary Hemorrhagic Telangiectasia in a Sudanese Patient.

Case Rep Med 2020 14;2020:6395629. Epub 2020 Dec 14.

Wad Medani Teaching Hospital, Wad Medani, Sudan.

Background: Hereditary hemorrhagic telangiectasia (HHT) also known as Osler-Weber-Rendu syndrome is a rare autosomal dominant disorder, which results in vascular dysplasia affecting mainly visceral and mucocutaneous organs. . A 65-year-old woman with a 12-year history of recurrent spontaneous epistaxis presented with shortness of breath, easy fatigability, and bilateral lower limb edema. Her family history was significant for definite hereditary hemorrhagic telangiectasia in first-degree relatives. During the previous 15 days, she has experienced three episodes of recurrent nasal bleeding. She has a background of chronic mitral regurgitation. Physical examination revealed telangiectases in her tongue, lower lip, and hand in addition to signs of congestive heart failure. The patient met 3\4 Curacao criteria and had a definite HHT. Her laboratory workup revealed a hemoglobin count of 5.4 g/dl. Echocardiography revealed a left systolic ejection fraction of 51% with left atrial dilatation and severe mitral regurgitation. Chest X-ray showed features of cardiomegaly and pulmonary edema. The abdominal ultrasonography showed enlarged liver size with homogenous texture and congested hepatic veins without features of hepatic AVMs. She was treated with intravenous frusemide, iron supplement, tranexamic acid, blood transfusion, and nasal packing.

Conclusions: HTT usually passes unnoticed in Sudan. The rarity of HHT, difficulties in affording diagnostic imaging studies, and low clinical suspicion among doctors are important contributing factors. Anemia resulting from recurrent epistaxis might have an influential role in precipitating acute heart failure in those with chronic rheumatic valvular disease.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2020/6395629DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7752298PMC
December 2020

Insertion of a biventricular assist device.

Multimed Man Cardiothorac Surg 2020 12 23;2020. Epub 2020 Dec 23.

The Royal Papworth Hospital, Cambridge, United Kingdom.

This video tutorial demonstrates the insertion of a temporary biventricular assist device as a bridge to a heart transplant in a patient with end-stage heart failure with decompensation and increasing pulmonary pressure . This technique utilizes cardiopulmonary bypass to maintain hemodynamic stability throughout the procedure. Transesophageal echocardiography is used to guide the correct positioning of the ventricular cannulae. The cannulation sites include the right ventricle and the pulmonary artery for the right ventricular assist device and the left ventricular apex and the ascending aorta for the left ventricular assist device. The patient is weaned off cardiopulmonary bypass as the biventricular assist device flows are increased to the desired level. Following chest closure, the patient can be ambulatory with the device in situ.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1510/mmcts.2020.072DOI Listing
December 2020

Decline in mild stroke presentations and intravenous thrombolysis during the COVID-19 pandemic: The Society of Vascular and Interventional Neurology Multicenter Collaboration.

Clin Neurol Neurosurg 2021 02 15;201:106436. Epub 2020 Dec 15.

Cooper Neurological Institute, Cooper University Hospital, Camden, NJ, 08103, USA.

Background: To evaluate overall ischemic stroke volumes and rates, specific subtypes, and clinical presentation during the COVID-19 pandemic in a multicenter observational study from eight states across US.

Methods: We compared all ischemic strokes admitted between January 2019 and May 2020, grouped as; March-May 2020 (COVID-19 period) and March-May 2019 (seasonal pre-COVID-19 period). Primary outcome was stroke severity at admission measured by NIHSS stratified as mild (0-7), moderate [8-14], and severe (>14). Secondary outcomes were volume of large vessel occlusions (LVOs), stroke etiology, IV-tPA rates, and discharge disposition.

Results: Of the 7969 patients diagnosed with acute ischemic stroke during the study period, 933 (12 %) presented in the COVID-19 period while 1319 (17 %) presented in the seasonal pre-COVID-19 period. Significant decline was observed in the mean weekly volumes of newly diagnosed ischemic strokes (98 ± 3 vs 50 ± 20,p = 0.003), LVOs (16.5 ± 3.8 vs 8.3 ± 5.9,p = 0.008), and IV-tPA (10.9 ± 3.4 vs 5.3 ± 2.9,p = 0.0047), whereas the mean weekly proportion of LVOs (18 % ±5 vs 16 % ±7,p = 0.24) and IV-tPA (10.4 % ±4.5 vs. 9.9 % ±2.4,p = 0.66) remained the same, when compared to the seasonal pre-COVID-19 period. Additionally, an increased proportion of patients presented with a severe disease (NIHSS > 14) during the COVID-19 period (29.7 % vs 24.5 %,p < 0.025). The odds of being discharged to home were 26 % greater in the COVID-19 period when compared to seasonal pre-COVID-19 period (OR:1.26, 95 % CI:1.07-1.49,p = 0.016).

Conclusions: During COVID-19 period there was a decrease in volume of newly diagnosed ischemic stroke cases and IV-tPA administration. Patients admitted to the hospital had severe neurological clinical presentation and were more likely to discharge home.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clineuro.2020.106436DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7836428PMC
February 2021

Availability, coverage, and scope of health information systems for kidney care across world countries and regions.

Nephrol Dial Transplant 2020 Dec 22. Epub 2020 Dec 22.

Centre for Kidney Disease Research, University of Queensland, Brisbane, QLD,Australia.

Background: Health information systems (HIS) are fundamental tools for the surveillance of health services, estimation of disease burden and prioritization of health resources. Several gaps in the availability of HIS for kidney disease were highlighted by the first iteration of the Global Kidney Health Atlas.

Methods: As part of its second iteration, the International Society of Nephrology conducted a cross-sectional global survey between July and October 2018 to explore the coverage and scope of HIS for kidney disease, with a focus on kidney replacement therapy (KRT).

Results: Out of a total of 182 invited countries, 154 countries responded to questions on HIS (85% response rate). KRT registries were available in almost all high-income countries, but few low-income countries, while registries for non-dialysis chronic kidney disease (CKD) or acute kidney injury (AKI) were rare. Registries in high-income countries tended to be national, in contrast to registries in low-income countries, which often operated at local or regional levels. Although cause of end-stage kidney disease, modality of KRT and source of kidney transplant donors were frequently reported, few countries collected data on patient-reported outcome measures and only half of low-income countries recorded process-based measures. Almost no countries had programs to detect AKI and practices to identify CKD-targeted individuals with diabetes, hypertension and cardiovascular disease, rather than members of high-risk ethnic groups.

Conclusions: These findings confirm significant heterogeneity in the global availability of HIS for kidney disease and highlight important gaps in their coverage and scope, especially in low-income countries and across the domains of AKI, non-dialysis CKD, patient-reported outcomes, process-based measures and quality indicators for KRT service delivery.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/ndt/gfaa343DOI Listing
December 2020

Availability, Accessibility, and Quality of Conservative Kidney Management Worldwide.

Clin J Am Soc Nephrol 2020 Dec 15;16(1):79-87. Epub 2020 Dec 15.

Division of Nephrology and Immunology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada

Background And Objectives: People with kidney failure typically receive KRT in the form of dialysis or transplantation. However, studies have suggested that not all patients with kidney failure are best suited for KRT. Additionally, KRT is costly and not always accessible in resource-restricted settings. Conservative kidney management is an alternate kidney failure therapy that focuses on symptom management, psychologic health, spiritual care, and family and social support. Despite the importance of conservative kidney management in kidney failure care, several barriers exist that affect its uptake and quality.

Design, Setting, Participants, & Measurements: The Global Kidney Health Atlas is an ongoing initiative of the International Society of Nephrology that aims to monitor and evaluate the status of global kidney care worldwide. This study reports on findings from the 2018 Global Kidney Health Atlas survey, specifically addressing the availability, accessibility, and quality of conservative kidney management.

Results: Respondents from 160 countries completed the survey, and 154 answered questions pertaining to conservative kidney management. Of these, 124 (81%) stated that conservative kidney management was available. Accessibility was low worldwide, particularly in low-income countries. Less than half of countries utilized multidisciplinary teams (46%); utilized shared decision making (32%); or provided psychologic, cultural, or spiritual support (36%). One-quarter provided relevant health care providers with training on conservative kidney management delivery.

Conclusions: Overall, conservative kidney management is available in most countries; however, it is not optimally accessible or of the highest quality.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2215/CJN.09070620DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7792657PMC
December 2020

A 5-year single-center early experience of heart transplantation from donation after circulatory-determined death donors.

J Heart Lung Transplant 2020 Dec 3;39(12):1463-1475. Epub 2020 Oct 3.

Department of Transplantation, Royal Papworth Hospital NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United Kingdom. Electronic address:

Background: In an effort to address the increasing demand for heart transplantation within the United Kingdom (UK), we established a clinical program of heart transplantation from donation after circulatory-determined death (DCD) donors in 2015. After 5 years, we report the clinical early outcomes and impact of the program.

Methods: This is a single-center, retrospective, matched, observational cohort study comparing outcomes of hearts transplanted from DCD donors from March 1, 2015 to February 29, 2020 with those from matched donation after brain death (DBD) donors at Royal Papworth Hospital (RPH) (Cambridge, UK). DCD hearts were either retrieved using thoracoabdominal normothermic regional perfusion or the direct procurement and perfusion technique. All DBD hearts were procured using standard cold static storage. The primary outcomes were recipient 30-day and 1-year survival.

Results: During the 5-year study, DCD heart donation increased overall heart transplant activity by 48% (79 for DCD and 164 for DBD). There was no difference in survival at 30 days (97% for DCD vs 99% for DBD, p = 1.00) or 1 year (91% for DCD vs 89% for DBD, p = 0.72). There was no difference in the length of stay in the intensive care unit (7 for DCD vs 6 for DBD days, p = 0.24) or in the hospital (24 for DCD vs 25 for DBD days, p = 0.84).

Conclusions: DCD heart donation increased overall heart transplant activity at RPH by 48%, with no difference in 30-day or 1-year survival in comparison with conventional DBD heart transplantations. DCD heart donation is set to make a dramatic difference in the number of patients who can benefit from heart transplantation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.healun.2020.10.001DOI Listing
December 2020

Predictors of immunization coverage among 12-23 month old children in Ethiopia: systematic review and meta-analysis.

BMC Public Health 2020 Nov 26;20(1):1803. Epub 2020 Nov 26.

Department of Population and Family Health, Jimma University, Jimma, Ethiopia.

Background: Immunization is one of modern medicine's greatest achievements in the last three decades. Annually it can prevent nearly 2 to 3 million deaths. Understanding the determinants of effective immunization coverage is a critical undertaking. Accordingly, we set out to check the best available evidence of outstanding predictors of immunization coverage among children aged 12-23 months in Ethiopia.

Method: Electronic databases including PubMed, Google Scholar, HINARI, and SCOPUS, Web of Science, African Journals Online, Ethiopian Medical Journals were searched. The search process, study selection, critical appraisal, and data extraction were done independently by two reviewers using Joanna Briggs Institute Meta-analysis for Review Instrument (JBI-MAStARI). The difference between reviewers was resolved with a third person. The risk of bias was assessed by the Newcastle Ottawa Tool for observational studies. Data were extracted using the Microsoft Excel checklist and exported to STATA 13. Heterogeneity was assessed using I, Funnel plot and Egger's test was used to check for publication bias.

Results: We identified 26 studies with 15,042 children with mothers/caretakers to assess factors associated with immunization coverage and significant factors were: maternal formal education, (OR = 2.45; 95% CI: 1.62-3.72), paternal formal education, (OR = 1.01; 95% CI: 0.27-3.77), residence, (OR = 2.11; 95% CI: 1.00-4.45), birth at health facility (OR = 1.86; 95% CI: 0.99-3.49), family size less than four, (OR = 1.81; 95% CI: 1.16-2.84), knowledge on age of immunization to be completed (OR = 6.18;95% CI: 3.07-12.43), knowledge on immunization schedule (OR = 2.49; 95% CI: 1.35-4.59), time to travel to health faculties, (OR = 1.74; 95% CI: 0.62-4.89), antennal care, (OR = 3.11; 95% CI: 1.64-5.88), and tetanus toxoid vaccination, (OR = 4.82; 95% CI: 2.99-7.75).

Conclusion: Our findings showed that literacy, residence, awareness, family size, maternal health services use, and proximity of the health facilities were factors associated with full immunization. This implies that there is a need for primary health service expansion and health education to "hard to reach areas" to improve immunization coverage for children aged 12-23 months.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12889-020-09890-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7689978PMC
November 2020

Oculocerebrocutaneous syndrome (Delleman Oorthuys syndrome) associated with congenital glaucoma: A case report.

Eur J Ophthalmol 2020 Nov 4:1120672120964696. Epub 2020 Nov 4.

Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Introduction: Oculocerebrocutaneous syndrome (Delleman Oorthuys syndrome) (OMIM 164180) is a rare syndrome affecting eyes, skin, and central nervous system, and it is usually associated with microphthalmia.

Case Description: A 4-day old baby boy was referred to our hospital for the evaluation of buphthalmos in the left eye. His clinical evaluation was remarkable for oculocerebrocutaneous syndrome with congenital glaucoma in the left eye and microphthalmos in the right eye.

Conclusion: Our report represents the first case of oculocerebrocutaneous syndrome associated with unilateral congenital glaucoma so far in the literature.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1120672120964696DOI Listing
November 2020

Risk Factors for Anemia Among Pregnant Women Attending the Antenatal Care Unit in Selected Jigjiga Public Health Facilities, Somali Region, East Ethiopia 2019: Unmatched Case-Control Study.

J Multidiscip Healthc 2020 10;13:769-777. Epub 2020 Aug 10.

Department of Public Health, College of Medicine and Health Science, Jigjiga University, Jigjiga, Ethiopia.

Background: Anemia is a significant public health concern in many developing countries, particularly during pregnancy, and it has adverse effects on mother and fetus/baby.

Objective: To determine the factors associated with anemia among pregnant women attending antenatal care in Jigjiga public health facilities, Somali Region, East Ethiopia.

Methods: An institution-based unmatched case-control study was conducted. The sample size was 228 pregnant women; comprising 114 presenting with anemia and 114 controls. Hemoglobin levels were measured using a portable heme analyzer. Socio-demographic, dietary, medical history, and nutrition-related data were collected using a structured questionnaire. Data were entered into Epidata 3.1 and exported to Statistical Package for the Social Sciences (SPSS) version 23.0 for cleaning and analyses. Bivariate and multivariate logistic regression was performed and statistical significance was considered at a level of p<0.05.

Results: Three predictors of anemia among pregnant women were identified in this study. An inadequate intake of red meat (i.e. those who consumed red meat 1-2 times a month [AOR=7.245; 95% CI=(2.007-26.151)] or not at all [AOR=8.690; 95% CI=(1.795-42.072)]), and insufficient consumption of green vegetables (i.e. 1-2 times a week [AOR=2.970; 95% CI=(1.012-8.716)] or 1-2 times a month [AOR=8.057; 95% CI=(2.358-27.526)]) were associated with anemia. Also, having a mid-upper arm circumference (MUAC) of less than 23 cm was strongly associated [AOR=16.432; 95% CI= (5.240-51.526)] with anemia.

Conclusion: This study revealed three key factors to be associated with anemia among pregnant women in Jigjiga Town, namely reduced intake of red meat and green vegetables, and low MUAC. Interventions including nutrition counselling and enrolling pregnant women with low nutritional status in nutritional programs should be the core components of anemia control strategies, needed to address the high prevalence of anemia during pregnancy in developing countries.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/JMDH.S260398DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428401PMC
August 2020

Disparities in end-stage kidney disease care for children: a global survey.

Kidney Int 2020 09;98(3):527-532

Centre for Kidney Disease Research, University of Queensland, Brisbane, Australia; Metro South and Integrated Nephrology and Transplant Services (MINTS), Princess Alexandra Hospital, Brisbane, Australia; Translational Research Institute, Brisbane, Australia.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.kint.2020.04.058DOI Listing
September 2020

Peritoneal Dialysis Use and Practice Patterns: An International Survey Study.

Am J Kidney Dis 2021 Mar 12;77(3):315-325. Epub 2020 Aug 12.

Centre for Kidney Disease Research, University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Metro South and Ipswich Nephrology and Transplant Services (MINTS), Princess Alexandra Hospital, Brisbane, Australia.

Rationale & Objective: Approximately 11% of people with kidney failure worldwide are treated with peritoneal dialysis (PD). This study examined PD use and practice patterns across the globe.

Study Design: A cross-sectional survey.

Setting & Participants: Stakeholders including clinicians, policy makers, and patient representatives in 182 countries convened by the International Society of Nephrology between July and September 2018.

Outcomes: PD use, availability, accessibility, affordability, delivery, and reporting of quality outcome measures.

Analytical Approach: Descriptive statistics.

Results: Responses were received from 88% (n=160) of countries and there were 313 participants (257 nephrologists [82%], 22 non-nephrologist physicians [7%], 6 other health professionals [2%], 17 administrators/policy makers/civil servants [5%], and 11 others [4%]). 85% (n=156) of countries responded to questions about PD. Median PD use was 38.1 per million population. PD was not available in 30 of the 156 (19%) countries responding to PD-related questions, particularly in countries in Africa (20/41) and low-income countries (15/22). In 69% of countries, PD was the initial dialysis modality for≤10% of patients with newly diagnosed kidney failure. Patients receiving PD were expected to pay 1% to 25% of treatment costs, and higher (>75%) copayments (out-of-pocket expenses incurred by patients) were more common in South Asia and low-income countries. Average exchange volumes were adequate (defined as 3-4 exchanges per day or the equivalent for automated PD) in 72% of countries. PD quality outcome monitoring and reporting were variable. Most countries did not measure patient-reported PD outcomes.

Limitations: Low responses from policy makers; limited ability to provide more in-depth explanations underpinning outcomes from each country due to lack of granular data; lack of objective data.

Conclusions: Large inter- and intraregional disparities exist in PD availability, accessibility, affordability, delivery, and reporting of quality outcome measures around the world, with the greatest gaps observed in Africa and South Asia.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1053/j.ajkd.2020.05.032DOI Listing
March 2021

Hemodialysis Use and Practice Patterns: An International Survey Study.

Am J Kidney Dis 2021 Mar 13;77(3):326-335.e1. Epub 2020 Aug 13.

Centre for Kidney Disease Research, University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Metro South and Ipswich Nephrology and Transplant Services (MINTS), Princess Alexandra Hospital, Brisbane, Australia. Electronic address:

Rationale & Objective: Hemodialysis (HD) is the most common form of kidney replacement therapy. This study aimed to examine the use, availability, accessibility, affordability, and quality of HD care worldwide.

Study Design: A cross-sectional survey.

Setting & Participants: Stakeholders (clinicians, policy makers, and consumer representatives) in 182 countries were convened by the International Society of Nephrology from July to September 2018.

Outcomes: Use, availability, accessibility, affordability, and quality of HD care.

Analytical Approach: Descriptive statistics.

Results: Overall, representatives from 160 (88%) countries participated. Median country-specific use of maintenance HD was 298.4 (IQR, 80.5-599.4) per million population (pmp). Global median HD use among incident patients with kidney failure was 98.0 (IQR, 81.5-140.8) pmp and median number of HD centers was 4.5 (IQR, 1.2-9.9) pmp. Adequate HD services (3-4 hours 3 times weekly) were generally available in 27% of low-income countries. Home HD was generally available in 36% of high-income countries. 32% of countries performed monitoring of patient-reported outcomes; 61%, monitoring of small-solute clearance; 60%, monitoring of bone mineral markers; 51%, monitoring of technique survival; and 60%, monitoring of patient survival. At initiation of maintenance dialysis, only 5% of countries used an arteriovenous access in almost all patients. Vascular access education was suboptimal, funding for vascular access procedures was not uniform, and copayments were greater in countries with lower levels of income. Patients in 23% of the low-income countries had to pay >75% of HD costs compared with patients in only 4% of high-income countries.

Limitations: A cross-sectional survey with possibility of response bias, social desirability bias, and limited data collection preventing in-depth analysis.

Conclusions: In summary, findings reveal substantial variations in global HD use, availability, accessibility, quality, and affordability worldwide, with the lowest use evident in low- and lower-middle-income countries.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1053/j.ajkd.2020.05.030DOI Listing
March 2021

Mortality in COVID-19 disease patients: Correlating the association of major histocompatibility complex (MHC) with severe acute respiratory syndrome 2 (SARS-CoV-2) variants.

Int J Infect Dis 2020 Sep 18;98:454-459. Epub 2020 Jul 18.

ImmunoSurgery Unit, Champalimaud Centre for the Unknown, Avenida Brasília, 1400-038 Lisbon, Portugal; I Medical Clinical, University of Mainz, Germany. Electronic address:

Genetic factors such as the HLA type of patients may play a role in regard to disease severity and clinical outcome of patients with COVID-19. Taking the data deposited in the GISAID database, we made predictions using the IEDB analysis resource (TepiTool) to gauge how variants in the SARS-CoV-2 genome may change peptide binding to the most frequent MHC-class I and -II alleles in Africa, Asia and Europe. We caracterized how a single mutation in the wildtype sequence of of SARS-CoV-2 could influence the peptide binding of SARS-CoV-2 variants to MHC class II, but not to MHC class I alleles. Assuming the ORF8 (L84S) mutation is biologically significant, selective pressure from MHC class II alleles may select for viral varients and subsequently shape the quality and quantity of cellular immune responses aginast SARS-CoV-2. MHC 4-digit typing along with viral sequence analysis should be considered in studies examining clinical outcomes in patients with COVID-19.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijid.2020.07.016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7368421PMC
September 2020

Understanding the factors affecting the humanitarian health and nutrition response for women and children in Somalia since 2000: a case study.

Confl Health 2020 27;14:35. Epub 2020 May 27.

Somali Disaster Resilience Institute, Mogadishu, Somalia.

Background: Somalia has been ravaged by more than two decades of armed conflict causing immense damage to the country's infrastructure and mass displacement and suffering among its people. An influx of humanitarian actors has sought to provide basic services, including health services for women and children, throughout the conflict. This study aimed to better understand the humanitarian health response for women and children in Somalia since 2000.

Methods: The study utilized a mixed-methods design. We collated intervention coverage data from publically available large-scale household surveys and we conducted 32 interviews with representatives from government, UN agencies, NGOs, and health facility staff. Qualitative data were analyzed using latent content analysis.

Results: The available quantitative data on intervention coverage in Somalia are extremely limited, making it difficult to discern patterns or trends over time or by region. Underlying sociocultural and other contextual factors most strongly affecting the humanitarian health response for women and children included clan dynamics and female disempowerment. The most salient operational influences included the assessment of population needs, donors' priorities, and insufficient and inflexible funding. Key barriers to service delivery included chronic commodity and human resource shortages, poor infrastructure, and limited access to highly vulnerable populations, all against the backdrop of ongoing insecurity. Various strategies to mitigate these barriers were discussed. In-country coordination of humanitarian health actors and their activities has improved over time, with federal and state-level ministries of health playing increasingly active roles.

Conclusions: Emerging recommendations include further exploration of government partnerships with private-sector service providers to make services available throughout Somalia free of charge, with further research on innovative uses of technology to help reaches remote and inaccessible areas. To mitigate chronic skilled health worker shortages, more operational research is needed on the expanded use of community health workers. Persistent gaps in service provision across the continuum must be addressed, including for adolescents, for example. The is also a clear need for longer term development focus to enable the provision of health and nutrition services for women and children beyond those included in recurrent emergency response.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13031-019-0241-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7254682PMC
May 2020

Screening of seaweeds for sustainable biofuel recovery through sequential biodiesel and bioethanol production.

Environ Sci Pollut Res Int 2020 Sep 6;27(26):32481-32493. Epub 2020 Jun 6.

Botany and Microbiology Department, Faculty of Science, Tanta University, Tanta, 31527, Egypt.

The present study evaluated the sequential biodiesel-bioethanol production from seaweeds. A total of 22 macroalgal species were collected at different seasons and screened based on lipid and carbohydrate contents as well as biomass production. The promising species was selected, based on the relative increase in energy compounds (REEC, %), for further energy conversion. Seasonal and annual biomass yields of the studied species showed significant variations. The rhodophyte Amphiroa compressa and the chlorophyte Ulva intestinalis showed the highest annual biomass yield of 75.2 and 61.5 g m year, respectively. However, the highest annual carbohydrate productivity (ACP) and annual lipid productivity (ALP) were recorded for Ulva fasciata and Ulva intestinalis (17.0 and 3.0 g m year, respectively). The later was selected for further studies because it showed 14.8% higher REEC value than Ulva fasciata. Saturated fatty acids (SAFs) showed 73.4%, with palmitic acid as a dominant fatty acid (43.8%). Therefore, biodiesel showed high saturation degree, with average degree of unsaturation (ADU) of 0.508. All the measured biodiesel characteristics complied the international standards. The first route of biodiesel production (R1) from Ulva intestinalis showed biodiesel recovery of 32.3 mg g dw. The hydrolysate obtained after saccharification of the whole biomass (R2) and lipid-free biomass (R3) contained 1.22 and 1.15 g L, respectively, reducing sugars. However, bioethanol yield from R3 was 0.081 g g dw, which represented 14.1% higher than that of R2. Therefore, application of sequential biofuel production using R3 resulted in gross energy output of 3.44 GJ ton dw, which was 170.9% and 82.0% higher than R1 and R2, respectively. The present study recommended the naturally-grown Ulva intestinalis as a potential feedstock for enhanced energy recovery through sequential biodiesel-bioethanol production.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11356-020-09534-1DOI Listing
September 2020

Distribution and metal contamination in core sediments from the North Al-Wajh area, Red Sea, Saudi Arabia.

Mar Pollut Bull 2020 Mar 17;152:110924. Epub 2020 Feb 17.

Marine Geology Department, Faculty of Marine Science, King Abdulaziz University, Saudi Arabia.

Forty-one bottom sediment samples were collected from three cores at the mouth of Wadi Haramel, Wadi Antar, Wadi Dumaygh, north of Al-Wajh, Red Sea, Saudi Arabia, to evaluate the levels of heavy metal contamination, using the enrichment factor (EF), geoaccumulation index (Igeo), contamination factor (Cf), soil pollution index (SPI), and multivariate statistical analysis (hierarchical cluster analysis and principal component analysis). Fe, Al, Pb, Mn, Cu, Ni, Co, Cd, Sr, V, Hg, and Total Organic Matter (TOM%) were quantified by Atomic Absorption Spectrophotometer. The vertical distribution of the heavy metals concentrations increased upwards indicating high heavy metals input. The results of enrichment factor and soil pollution index calculations indicate a strong anthropogenic supply of Cd and Sr (SPI = 1.10, 2.70, EF = 18.25, 17.99 respectively) while Cu and Ni show moderate anthropogenic input from urban, industrial activities and some new projects in the northern coast of Saudi Arabia.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.marpolbul.2020.110924DOI Listing
March 2020

Prosthesis-Patient Mismatch Increases Early and Late Mortality in Low Risk Aortic Valve Replacement.

Semin Thorac Cardiovasc Surg 2021 Spring;33(1):23-30. Epub 2020 May 18.

Royal Papworth Hospital, Cardiac Surgery Department, Cambridge Biomedical Campus, Cambridge, UK.

The concept of prosthesis-patient mismatch (PPM) has gained much attention since first described 40 years ago. Previous studies have shown conflicting evidence regarding increased early and late morbidity and mortality with PPM after aortic valve replacement (AVR). The aim of this study was to evaluate the effects of PPM on short- and long-term mortality in low-risk patients after isolated AVR. A retrospective, single-center study involving 1707 consecutive patients ≤80 years of age with preserved left ventricular systolic function who underwent elective, primary isolated AVR operations from 2008 to 2018. Patients were stratified into 2 groups according to the presence of PPM (n = 96), defined as effective orifice area index <0.85 cm/m body surface area, and no-PPM (n = 1611). The effect of PPM on mortality was evaluated with univariate and multivariate analyses. 30-day mortality was 0.8% (4.2% in PPM group vs 0.6 in no-PPM group; P = 0.005). PPM occurred more in female gender, obese and older patients. PPM was highly associated with long-term all-cause mortality (median 4 years [Q1-Q3 2-7]; HR: 1.79, 95% CI: 1.27-2.55, P = 0.002), and remained strongly and independently associated after adjustment for other risk factors (HR: 1.60, 95% CI: 1.10-2.34, P = 0.014). In propensity score-matched analysis, the adjusted mortality risk was higher in PPM group (HR: 2.03, 95% CI: 1.22-3.39, P = 0.006) compared to no-PPM group. In a single-centre observational study, PPM increased early mortality and was independently associated with long-term all-cause mortality after low-risk, primary isolated AVR operations. Strategies to avoid PPM should be explored and implemented.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1053/j.semtcvs.2020.05.006DOI Listing
May 2020

Reducing mortality and morbidity in patients with severe COVID-19 disease by advancing ongoing trials of Mesenchymal Stromal (stem) Cell (MSC) therapy - Achieving global consensus and visibility for cellular host-directed therapies.

Int J Infect Dis 2020 Jul 17;96:431-439. Epub 2020 May 17.

Medical Clinic, University Medical Center Mainz, Germany; Champalimaud Centre for the Unknown, Lisbon, Portugal. Electronic address:

As of May 17th 2020, the novel coronavirus disease 2019 (COVID-19) pandemic has caused 307,395 deaths worldwide, out of 3,917,366 cases reported to the World Health Organization. No specific treatments for reducing mortality or morbidity are yet available. Deaths from COVID-19 will continue to rise globally until effective and appropriate treatments and/or vaccines are found. In search of effective treatments, the global medical, scientific, pharma and funding communities have rapidly initiated over 500 COVID-19 clinical trials on a range of antiviral drug regimens and repurposed drugs in various combinations. A paradigm shift is underway from the current focus of drug development targeting the pathogen, to advancing cellular Host-Directed Therapies (HDTs) for tackling the aberrant host immune and inflammatory responses which underlie the pathogenesis of SARS-CoV-2 and high COVID-19 mortality rates. We focus this editorial specifically on the background to, and the rationale for, the use and evaluation of mesenchymal stromal (Stem) cells (MSCs) in treatment trials of patients with severe COVID-19 disease. Currently, the ClinicalTrials.gov and the WHO Clinical Trials Registry Platform (WHO ICTRP) report a combined 28 trials exploring the potential of MSCs or their products for treatment of COVID-19. MSCs should also be trialed for treatment of other circulating WHO priority Blueprint pathogens such as MERS-CoV which causes upto 34% mortality rates. It's about time funding agencies invested more into development MSCs per se, and also for a range of other HDTs, in combination with other therapeutic interventions. MSC therapy could turn out to be an important contribution to bringing an end to the high COVID-19 death rates and preventing long-term functional disability in those who survive disease.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijid.2020.05.040DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7231497PMC
July 2020

Bariatric surgery and transplantation: A bridge not so far.

Am J Transplant 2020 09 13;20(9):2621-2622. Epub 2020 May 13.

Department of Multi-Organ Transplantation, University of Western Ontario, London, Canada.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/ajt.15946DOI Listing
September 2020

An improved growth medium for enhanced inoculum production of the plant growth-promoting fungus .

Plant Methods 2020 16;16:39. Epub 2020 Mar 16.

1Julius-Von-Sachs Institute of Biosciences, Biocenter, Pharmaceutical Biology, Julius-Maximilians-Universität Würzburg, Julius-von-Sachs-Platz 2, 97082 Würzburg, Germany.

Background: The plant endophytic fungus colonizes roots of a wide range of plant species and can enhance growth and stress resistance of these plants. Due to its ease of axenic cultivation and its broad host plant range including the model plant Arabidopsis thaliana and numerous crop plants, it is widely used as a model fungus to study beneficial fungus-root interactions. In addition, it was suggested to be utilized for commercial applications, e.g. to enhance yield in barley and other species. To produce inoculum, is mostly cultivated in a complex Hill-Käfer medium (CM medium), however, growth in this medium is slow, and yield of chlamydospores, which are often used for plant root inoculation, is relatively low.

Results: We tested and optimized a simple vegetable juice-based medium for an enhanced yield of fungal inoculum. The described vegetable juice (VJ) medium is based on commercially available vegetable juice and is easy to prepare. VJ medium was superior to the currently used CM medium with respect to biomass production in liquid medium and hyphal growth on agar plates. Using solid VJ medium supplemented with sucrose (VJS), a high amount of chlamydospores developed already after 8 days of cultivation, producing significantly more spores than on CM medium. Use of VJ medium is not restricted to , as it also supported growth of two pathogenic fungi often used in plant pathology experiments: the ascomycete , the causal agent of Fusarium head blight disease on wheat and barley, and , the causal agent of verticillium wilt.

Conclusions: The described VJ medium is recommended for streamlined and efficient production of inoculum for the plant endophytic fungus and might prove superior for the propagation of other fungi for research purposes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13007-020-00584-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7076966PMC
March 2020

Computer access of morning report/ Harrison Club PowerPoint presentations to the medicine residents has improved their confidence in management and in preparation for the monthly exams and for the American Board of Internal Medicine: an innovative education quality improvement project at Harlem Hospital center.

J Community Hosp Intern Med Perspect 2020 10;10(1):6-9. Epub 2020 Feb 10.

Department of Medicine, Harlem Hospital in affiliation with Columbia University Medical Center, New York, USA.

: Morning report is an important conventional teaching activity of residency programs worldwide. : We aimed at creating a shared digital folder of the morning report/Harrison Club presentations for the training year of 2018-2019. Our primary objective was to assess the residents' satisfaction regarding its accessibility, as well as to estimate the percentage of residents who felt improvement in confidence levels in their management skills and their preparation for the monthly exams and for the American Board of Internal Medicine (ABIM). : This study is a cross-sectional study comparing the three different Post-Graduate Year residents. An anonymous questionnaire was distributed to 44 participating residents, and a multivariate analysis test was conducted. : Most of the residents thought the morning report/Harrison Club folder was easily accessible. 86.7%, 82.4% and 83.3% found it valuable to improve their confidence in management; 80%, 70.6% and 83.3% found it valuable to improve their confidence in preparation for the monthly exams; and 86.7%, 82.4% and 83.3% found it valuable to improve their confidence in preparing for the ABIM among the PGY1, PGY2, and PGY3 residents, respectively. : Almost all the residents agreed that they would recommend adoption of a similar digital tool in other residency programs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/20009666.2019.1710947DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034464PMC
February 2020

Effect of zinc oxide nanoparticles on broilers' performance and health status.

Trop Anim Health Prod 2020 Jul 3;52(4):2043-2054. Epub 2020 Feb 3.

Physics Department, Faculty of Science, Assiut University, Assiut, 71515, Egypt.

The current study investigated the effects of zinc oxide nanoparticles (ZONPs) and oxytetracycline (OTC) supplementation on broilers' behavior, performance, carcass quality, biochemical parameters, and intestinal microbial populations and birds' response to Newcastle disease (ND) vaccine. A total of 336 seven-day-old IR broiler chicks were randomly allotted to six dietary treatments containing 0, 10, 20, 30 and 40 ppm ZONPs or 50 ppm OTC. Each diet was fed to 7 replicates (8 birds/pen). The results clarified that 10 ppm ZONPs significantly improved the body weight gain and feed conversion in comparison to the control. No changes in behavior were recorded. The 10 ppm and 30 ppm ZONPs and OTC significantly reduced the gizzard weight in comparison to the control. While, 10 ppm ZONPs significantly increased the spleen weight, and all ZONPs doses increased bursa weight in comparison to the control and OTC groups. 20 ppm ZONPs increased the eviscerated yield and edible yield in comparison to the control and OTC groups. 40 ppm ZONPs increased pH, reduced meat color and overall acceptability in comparison to the control. In addition, results revealed that the 20 ppm ZONPs increased Calcium (Ca), High density low cholesterol (HDL-C), reduced urea (UA) and triglyceride (TG). Also, 40 ppm ZONPs and OTC increased creatinine (Cr) and reduced ND-HI titer in comparison to the control. For microbial population, OTC group was significantly lower than ZONPs groups in the total anaerobic, aerobic and lactobacilli count. In conclusion, the dietary inclusion of ZONPs can be applied as antibiotic growth promoter substitutions in broilers' diet. However, further investigations are still needed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11250-020-02229-2DOI Listing
July 2020

Device stability and quality of ventilation of classic laryngeal mask airway versus AIR-Q and I-gel at different head and neck positions in anesthetized spontaneously breathing children.

Minerva Anestesiol 2020 Mar 8;86(3):286-294. Epub 2020 Jan 8.

Department of Anesthesia and Intensive Care, Faculty of Medicine, Assiut University, Assiut, Egypt.

Background: Since its introduction into clinical practice, the use of laryngeal mask airway (LMA) has been dramatically increasing. We aimed to investigate the clinical performance of single use LMA classic, AIR-Q and I-gel at different head and neck positions and during the operative procedure in pediatric elective day case surgery.

Methods: One hundred sixty-eight generally anesthetized spontaneously breathing children (2-9 years) were randomized to receive either LMA classic (N.=56), I-gel (N.=58) or AIR-Q (N.=54). The oropharyngeal leak pressure (OLP), exhaled tidal volume (TV), peak inspiratory pressure (PIP), ventilation score and fiberoptic glottis view score were assessed at neutral position then at maximum flexion, extension and left rotation. Afterwards, the ventilation and fiberoptic view scores were assessed in neutral position at fixed time-points until end of surgery.

Results: Compared to neutral position, maximum neck flexion increased OLP (P=0.000) and compromised the ventilation leading to increased PIP, decreased TV, worsening of ventilation score and fiberoptic glottis view. OLP mildly decreased with extension and left lateral rotation with mild effect on ventilation parameters (P<0.05). At all neck positions, the OLP was higher (P=0.000) and ventilation parameters were better with I-gel (P=0.000). Gradual worsening of ventilation score and fiberoptic view grade was recorded intraoperatively with the three devices, with the least deterioration observed in I-gel group (P=0.000).

Conclusions: Having the highest increase in OLP at neck flexion, the I-gel LMA exhibited the best ventilation parameters and fiberoptic view grade at different head and neck positions and throughout the intraoperative period.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.23736/S0375-9393.19.13976-4DOI Listing
March 2020