Performance of two SARS-CoV-2 rapid antigen detection tests in resource limited settings, the case of Mali

Introduction: While real-time reverse transcription PCR (RT-PCR) is the recommended laboratory method to diagnose severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection, its use in resource limited settings can be difficult to maintain due to high testing demand and shortage of reagents. The aim of this study was to evaluate the performances of Realy Tech™ and Standard Q™ in comparison to RT-PCR in a relatively low COVID-19 prevalence setting, Mali. Methods: We conducted a cross-sectional study between January and April 2021 in Bamako and Kati regions to evaluate both rapid tests during a large SARS-CoV-2 prevalence study in Mali. Results: Of the 390 samples tested, the sensitivity and specificity of Realy Tech™ and Standard Q™ were 57.1% (95%CI: 44.1-69.2), 95.8% (95%CI: 93.1-97.5); 61.9% (95%CI: 46.8-75.0), and 94.1% (95%CI: 89.5-96.8) respectively. Using RT-PCR, the global prevalence of SARS-CoV-2 was 14.4% (56/390). In both rapid antigen tests, the performance was better when used in suspected patients compared to positive patients under treatment. Moreover, higher viral loads equivalent to Ct < 25 were associated with better detection rates. Conclusion: While waiting for more complete data, these preliminary studies suggest that Realy Tech™ and Standard Q™ should not be used alone for COVID-19 diagnosis in Mali.

Prevalence and Clinical Predictors of Heparin Induced Thrombocytopenia

Back Ground: Heparin induced thrombocytopenia (HIT) isthrombocytopenia or thrombosis with one or more positivetests for HIT antibodies. To diagnose HIT, platelet countmonitoring; at least every other day until hospital discharge forday 14 (whichever occurs sooner). A platelet count fall of 50%or greater from baseline or any thrombosis occurs 5 to 10 daysafter heparin starting with exclusion or other causes ofthrombocytopenia are highly suggestive of HIT. Laboratoryconfirming assays are helpful as platelet activations assay.Management of HIT includes discontinuing of any type ofheparin and using an alternative anticoagulant as DTIs(liperudin, argatropan, bivalerudin). Warfarin should be delayedpending substantial recovery of the platelet account.Methods: This study was conducted to 100 patients receivingheparin in a variety of clinical settings to assess the prevalenceof HIT trying to identify clinical predictors of such complication.To all these patients platelet count every other day from baseline to day 14 was done then the 4T score system was appliedto all patients.Results: Only 6 patients developed HIT; 4 of them developedthrombosis and 3 patients died in hospital due to thesethromboembolic events. UFH, surgical treatment and firstheparin exposure were the clinical predictors of HIT.Conclusion: HIT is a serious and life threatening complicationof heparin therapy that should be early diagnosed and properlymanaged to prevent its thromboembolic complications.

Phytochemical and biological studies of Butia capitata Becc. leaves cultivated in Egypt

Objective: To study the antioxidant and anti-inflammatory activity of Butia capitata (B. capitata) leaf extracts along with phytochemical analysis of the proposed bioactive constituents.Methods:organic solvents and screened for their anti-inflammatory activities in tested animals and in-vitro antioxidant effect. An extensive phytochemical investigation of the bioactive extracts through paper chromatography, thin layer chromatography, column chromatography, gas-liquid chromatography (GLC), high pressure liquid chromatography and spectral analysis. GC-Mass, ultraviolet, hydrogen and carbon nuclear magnetic resonance, electron ionization-mass spectrometry, heteronuclear multiple bond correlation and heteronuclear multiple quantum correlation were carried out.Results:Results showed that different extracts possess promising antioxidant effect and Different successive extracts of B. capitata Becc. leaves were prepared with selective significant anti-inflammatory activity with variable degrees. The results of the phytochemical investigation of the bioactive extracts revealed the presence of volatile substances, lipoidal matter, α-tocopherol, free sugars, polysaccharides and flavonoidal compounds.Conclusions: B. capitata leaf extracts were shown to possess variable antioxidant effect, the most promising was methanol extract. Both polar and non polar extracts were proved to have anti-inflammatory activity, the non polar extract was superior in this respect. The bioactivity of the extracts was ascribed to the presence of flavonoids, sterols and α-tocopherol.

Development of a remediation program for Egyptian dyslexic children

The present study was designed to formulate a remediation program for Arabic speaking children suffering from dyslexia based on improving phonological awareness using materials appropriate for Arabic culture. The study was carried out at the unit of Phoniatrics, Faculty of Medicine, Alexandria main university hospital. The subjects were divided into two groups.Group I: 30 dyslexic children of both sexes in the age range of 6[1/2]-10[1/2] years on which the proposed remediation programme was applied. Group II: 30 dyslexic children age and sexmatched were included as a control group; they received no remediation programs during the time of conduction of the study. The formulated Arabic remediation program was based on improving the phonological awareness for dyslexic children, after the Phonological Awareness Training for Reading Program. Modifications and additions were made to suit the nature of the Arabic language, and face the differences between Arabic and English orthography. The program was divided into sound blending, sound segmenting, reading and spelling activities. The training program was applied twice weekly, with session duration lasting from 25 to 30 min. Each session had about 2 or 3 children. The studied groups were subjected to protocol for evaluation of dyslexia before and after therapy to document to evaluate the improvement and the stability in the condition of these children. The presented training program significantly improved reading, writing and phonological awareness of dyslexic cases. The present study highlighted the importance of phonological awareness skills as a prerequisite for emergence of literacy skills. The program was modified to suit Arabic speaking Egyptian children. The study found that the age of the child is the most important predictor factor, the younger the age of intervention the better the outcome of therapy program

Serum asymmetric dimethyl arginine [ADMA], nitric oxide [NO] and homocystine [HCY] levels in behcet's disease as biomarkers of endothelial cell dysfunction

To measure the serum levels of asymmetric dimethyl arginine [ADMA], nitric oxide [NO] and homocystine [Hcy] in patients with Behcet's disease as markers of endothelial cell dysfunction and to explain their role [s] in the disease pathogenesis and activity. This study included 14 male patients with Behcet's's disease and 10 age and sex matched healthy volunteers. Patients were divided into two groups: mucocutaneous and vasculitis groups. CBC, deferential leucocytic counts, ESR, CRP were performed as a guide for disease activity. ADMA, NO and homocystine, was measured in the serum of all studied groups by ELISA. Duplex ultrasono graphics of venous and arterial system were done for vasculitis group. There was significant increase in ADMA level in BD patients [0.918 +/- 0.240 micro mol/L] than control group [0.0.401 +/- 0.070 micro mol/L] with increase in vasculitis group [1.133 +/- 0.223 micro mol/L] than mucocutaneous group [0.756 +/- 0.049 micro mol/L]. The study reported significant decrease in NO level in BD patients [11.986 +/- 1.815 micro mol] than the control group [14.560 +/- 1.897 micro mol/L] with significant decrease in vasculitis group [10.333 than +/- 0.647 micro mol/L] than mucocutaneous group [13.225 +/- 1.312 micro mol/L]. There was also significant increase in Hey level in BD patients [25.271 +/- 4.980 micro mol/L] than control group [10.020 +/- 1.060 micro mol/L] with significant increase in vasculitis group [30.53 3 +/- 1.141 micro mol/L] than mucocuteneous group [21.325 +/- 1.896 micro mol/L. Increased ADMA with decrease NO and increase Hcy serum levels may be responsible for endothelial damage in BD and can be used as markers for endothelial cell dysfunction

Development of an Arabic test for assessment of dyslexia in Egyptian children

The present study was designed to formulate and modify a test to assess dyslexia in Arabic speaking children. The study works to establish its reliability and validity by comparing the performance of normal and dyslexic children, and hence providing a profile of strengths and weaknesses which can be used as a guide for the remedial program of these children. Forty dyslexic children and 120 normal children were subjected to thorough history taking, full clinical examination; including general examination, ear nose and throat examination, conventional neurological evaluation, ophthalmological and audiological evaluation, in addition to psychometric evaluation and language assessment. Formulation of the Arabic Dyslexia Assessment Test [ADAT] was done to suit Egyptian children. The test assessed the following items Rapid naming, Bead threading, One minute reading, Postural stability, Phonemic segmentation, Two minute spelling, backward digit span, Nonsense passage reading, One minute writing, Verbal fluency, and Semantic fluency. It was applied on normal and dyslexic children to test its validity and reliability. Test reliability was proven using test - retest method where the cases and the controls were retested 2 weeks from the original test date. Test validity was measured by Face validity and Construct validity. The results of the Arabic dyslexia assessment test were highly significant in discriminating dyslexics from non dyslexic children. The high validity and reliability of the formulated test proves the sensitivity and specificity of the test

Role of misoprostol in dysfunccctional uterinee bleeding

This study included 128 patients between 18-49 years of age presenting with dysfunctional uterine bleeding [DUB]. They were initially assessed by general, pelvis examination as well as ultrasound of the pelvis. Women who were at high risk for endometrial cancer might be assessed by hysteroscopy and endometrial biopsy. All patients of dysfunctional uterine bleeding received misoprostol in the form of 400 mug rectally, followed by 400 mug orally every 8 hours for three days. In each cycle, the results were recorded. The efficacy of treatment was assessed in terms of a reduction in the amount of blood loss, Hb level and patient satisfaction. Also, the side effects of misoprostol in the form of GIT upset were assessed. The results showed that 128 out of 800 patients were diagnosed as having DUB. The response rate was 20.3% with misoprostol. The patient satisfaction was acceptable and its side effects were minimal

Cardiovascular risk factors in patients with end stage renal failure on regular hemodialysis

To investigate the relation between both fibrinogen, C-reactive protein [CRP], hemocysteine [Hcy], lipoprotein a [Lpa], as a non traditional cardiovascular [CV] risk factors, plasma lipids, hypertension, smoking and the occurrence and severity of ischemic heart disease [IHD] in patients with end stage renal failure [ESRF] on regular hemodialysis [HD] and weather diabetic patients are a high risk than non diabetic. 50 ESRF patients on regular HD divided into 3 groups Group I included 10 patients free from IHD as control. Group II : included 20 non-diabetic patients. Group III :included 20 type 2 diabetic patients. Both group II, III suffer from IHD. All patients were subjected to full history, clinical examination, routine investigations, evaluation of fibrinogen, quantitative CRP, serum Hcy Lpa, HDL, LDL cholesterol, triglycerides.12-leads surface ECG, resting and dobutamine stress echocardiography [DSE] were also done. Plasma fibrinogen was significantly higher in group III compared to both group I, II [F=20.2, P < 0.001]. There was significant increase in serum CRP in group II compared to I, III and in group III compared to group I [F=19.57, 0.001]. Plasma total Hcy was significantly higher in group II, and III compared to group I [F = 9 .27, P < 0.001], [pa was significantly increased in group II, III compared k group I while there was non significant difference between group II and III [F=6 .9 P > 0.05]. Interventricular septal thickness was significantly higher in group II .III compared to group I [F=5.2, P < 0.009]. Left ventricular posterior wall thickness was significantly increased in group II compared to group I [P < 0.001]. Dobutamine stress echo wall motion score [WMS] and wall motion score index [WMSI] were significantly higher in group II, and III compared to group I [F = 28.8, P < 0.001] and [F=27.4, P < 0.001] respectively. Factorial analysis and multiple regression analysis for cardiovascular risk factors revealed that high fasting blood glucose, fibrinogen, [pa. and dyslipideamia were independent risk factors in ESRF patients on regular HD [t 3.52 p < 0.001, t 3.26 p < 0.002, t 2.76 p < 0.008, t 2.19 p < 0.034, respective1y]. In conclusion, there are a considerable traditional and non traditional CV risk factors may affect ESRF patients on regular HD. Of them diabetes mellitus is the highest followed by elevated plasma fibrinogen, plasma Lpa, and dyslipidemia

Fetal Fibronectin in cervical and vaginal secretions as a predictor of preterm delivery

To evaluate the detection of fetal fibronection in cervico-vaginal secretions of patients with symptoms suggestive of preterm labour, as a predictor of preterm birth, 235 women presenting to the delivery suite between 24 to 37 weeks of gestation were selected. Speciemens of cervico-vaginal secretions were collected and fetal fibronectin levels were measured by >/= ELISA. Samples were considered positive if the level was >/= 005 ug/ml. It was found that fetal fibronection predicted preterm labour with positive predictive value of 80.76%, negative predictive value of 89.61%, sensitivity of 68.85% and specificity of 94.25%. Analysis of the data from women at less than 34 weeks of gestation showed similar results. Of the negative fetal fibronectin results obtained upon admission, 96.75% of women delivered after 7 days. It was concluded that fetal fibronectin appears as a promising marker for predicting preterm delivery in high risk women. However, only when we fully understand how the mechanisms underlying the release and their initiation are related to the processes leading to labour, will the full potential of the test be realized

Randomised Trial of Endometrial Laser Ablation [ELA], Transcervical Resection of the Endometrium [TCRE], and Thermal Balloon Ablation [TBA] for the treatment of menorrhagia

A randomised controlled trial was set up to compare the safety and clinical efficacy of endometrial ablation in the treatment of menorrhagia, performed either with ELA, TCRE or TBA. A total of 120 women with menorrhagia were selected and randomly allocated to ELA [GI], TCRE [GII] or TBA [GIII]. The main outcome measures were operative complications, post-operative recovery, relief of, menstrual and other symptoms, need for further surgical treatment, satisfaction with treatment at 6 and 12 months, postoperatively. It was found that the operating and theatre times were significantly shorter in TBA, than ELA or TCRE. However, there was no significant difference between the three groups as regard the complication rates, concomitant surgery, morbidity and duration of hospital stay. Also, it was found that there was significant improvement in bleeding and pain scores dysmenorrhoea and premenstrual symptoms at 6 and 12 months, in each group. Overall satisfaction levels were high. It was concluded that endometrial ablation is a reliable, safe alternative to hysterectomy for the treatment of monorrhagia. TBA is a safe and effective option. The procedure is simple, allowing the learing curve to be almost negligible

Nurses knowledge and perception related to foot care for older persons

The purpose of the study was to examine nurses knowledge and perceptions related to foot care of older persons. Students representing Public Health Nursing and Medical Surgical Nursing of the academic year [1991-1992] were surveyed. Also, the sample included all nurses working at Geriatric Homes in Alexandria and Geriatric Units of the Main University Hospital of Alexandreia. Data were collected using a foot care Survey with questions related to nurses' role with foot care of older adults, importance of various components of patient teaching content and knowledge about foot care. Comparisons were made between Medical Surgical Nursiong students, Public Health Nursing students, and nurses working at Geriatric Homes and Units. Chi-Square technique was used to compare the differences between the three groups. The present study revealed that nurses possessed the knowledge, but had not had the opportunity to acquire the associated foot care skills

nurse and mother as dental heath educators: their knowledge, attitudes and behaviors

Concerns about the dental health status of the five-years-old children in Egypt stimulated discussion about the prevention of dental caries. Preschool children should be a target group to reduce the prevalence of and try to prevent dental caries in that vulnerable age group. However, questions concerning who should conduct the dental health education remain unanswered. The ideal person to conduct the initial dental health education would be an individual who is readily available, accessible, and acceptable to both mother and child. The nurse, school health visitor and mothers fulfill these criteria. Furthermore, the nurses or school health visitors or mothers have access both to the clients in their own homes and to the community networks. In this way they can be involved with prevention at an individual counseling level as well as with influencing dental health as part of an over all health promotion strategy. The importance of involving the parents especially the mothers in dental health education has been demonstrated. Parents serve as role models as well as assist the young child to care for his teeth. The aim of this study was to identify the knowledge, attitudes and behaviors of the nurses and mothers as dental educators. A questionnaire specially designed for this study was completed by nurses working in schools, hospitals, MCH Centers as well as mothers. Revealed positive attitudes toward dental health education and lack of knowledge. However, tooth brushing was the only dental health behavior mentioned by some of nurses and mothers