The SARS-COV2 (COVID-19) Pandemic: What Clinicians should Know

In late 2019, a novel coronavirus, now designated SARS-CoV-2, emerged and was identified as the cause of an outbreak of acute respiratory illness in Wuhan, a city in China, named as COVID-19. Since then the waves of the virus exponentially hit many countries around the globe with high rates of spread associated with variable degrees of morbidity and mortality. The WHO announced the pandemic state of the infection in March 2020 and by June 1st 2020 more than 6 million individuals and more than 370 thousands case fatalities were documented worldwide. In this article, we discussed many aspects regarding this emerged infection based on the available evidence aiming to help clinician to improve not only their knowledge but also their practices toward this infection.

The SARS-COV2 (COVID-19) Pandemic: What Clinicians should Know

In late 2019, a novel coronavirus, now designated SARS-CoV-2, emerged and was identified as the cause of an outbreak of acute respiratory illness in Wuhan, a city in China, named as COVID-19. Since then the waves of the virus exponentially hit many countries around the globe with high rates of spread associated with variable degrees of morbidity and mortality. The WHO announced the pandemic state of the infection in March 2020 and by June 1st 2020 more than 6 million individuals and more than 370 thousands case fatalities were documented worldwide. In this article, we discussed many aspects regarding this emerged infection based on the available evidence aiming to help clinician to improve not only their knowledge but also their practices toward this infection.

Evaluation of antibacterial activity of silver nanoparticles against multidrug-resistant gram negative bacilli clinical isolates from Zagazig University Hospitals

Background: The growing incidence of multidrug resistant (MDR) bacterial infections has become a public health crisis. This work aims to evaluate the in-vitro activity of silver nanoparticles (AgNPs), alone and in combination with the antimicrobials amikacin and ceftazidime, against MDR Gram-negative bacilli (GNB) isolated from clinical cases in Zagazig University Hospitals. Methods: In a cross sectional study, MDR GNB were isolated from different clinical specimens and were tested to determine the minimal inhibitory concentration (MIC), minimal bactericidal concentration (MBC) and bactericidal activity of AgNPs using broth microdilution method. The effect of combining subMIC levels of AgNPs (MIC/2 and MIC/4) with amikacin and ceftazidime, was also determined by broth microdilution. Results: A total of 63 MDR GNB was obtained during the study period (22 E. coli, 17 Klebsiella, 15 Pseudomonas aeruginosa and 9 Acinetobacter isolates). AgNPs demonstrated a bactericidal effect on all tested isolates with an MBC/MIC ratio of less than 4. When combined with amikacin, a synergistic effect was demonstrated on all tested E.coli and Klebsiella isolates at AgNPs MIC/2 and on 45.4%, 40% and 77.8% of E.coli, P.aeruginosa and Acinetobacter isolates, respectively at MIC/4. In combination with ceftazidime, AgNPs exhibited a synergistic effect on 100% of E. coli and 88.2% Klebsiella at both MIC/2 and MIC/4 and on 40% of P. aeruginosa isolates at AgNPs MIC/4. Conclusions: AgNPs exert a bactericidal activity on MDR GNB as well as a synergistic effect when combined with amikacin and ceftazidime suggesting them as a new weapon in the war against MDR GNB

rate and reasons for discharge against medical advice

Objective: To evaluate the rate and reasons for discharge against medical advice

Design: A Prospective Cross-Sectional Study

Setting: King Hamad University Hospital, Bahrain

Method: All patients discharged against medical advice [DAMA] from the Emergency Medicine Department [EMD] and in-patients from 1 August 2015 to 31 December 2015 were included in this study

A preformed questionnaire was given to the patient or the family members who signed DAMA form

The data were analyzed using SPSS version 19.0

Result: Two hundred and ninety-nine patients were DAMA; the reasons for DAMA for adults and children combined were: 86 [28.8%] feeling better, 61 [20.4%] children at home, 51 [17.1%] long waiting time, 45 [15%] do not agree with the procedure or operation advised, 29 [9.7%] external obligations, 16 [5.4%] wish to have other treatment or consultation, 6 [2%] financial reasons, 3 [1%] dissatisfaction with medical or nursing care, 1 [0.3%] going on holiday and 1 [0.3%] the hospital does not allow husband to stay with his wife in the room

The rate of DAMA signed by patients is relatively high when EMD was considered. However, it was relatively low percentage when inpatient admission was taken into consideration

Conclusion: Our study revealed several predictors, which could be used for healthcare improvement

Frequency of cholelithiasis in patients with chronic liver disease: a hospital-based study

Background and study aim: Liver Cirrhosis is a strong and a common known risk factor for Cholelithiasis. Cholelithiasis is a multifactorial disease, based on a complex interaction of environmental and genetic factors. The primary aim of this study is to determine the frequency of cholelithiasis in chronic liver disease (CLD) patients admitted to Zagazig university hospitals. The secondary aim is to determine the risk factors and their association with the underlying etiology and severity of liver disease.Patients and Methods: We conducted a hospital based study including 131 patients with chronic liver disease based on clinical, laboratory and Ultrasonographic findings. Demographic, clinical and etiological data were recorded, using a pre-coded questionnaire. A number of laboratory tests as fasting plasma glucose, total cholesterol, triglyceride, aspartate aminotransferase (AST), alanine amino-transferase (ALT), alkaline phosphatase (ALP), hepatitis B surface antigen (HBsAg), and antibody to hepatitis C virus (HCV-Ab) were analyzed.Results: The number of registered cases was 131 with age (52.9±11.7).There were 55 (42%) males and 76 (58%) females. Hepatitis C (HCV) was present in 101 (77%) cases. The prevalence of cholelithiasis was 50.4%% (66 of 131 patients). Most of cholelithiasis patients presented with child C stage (68.2%), followed by child B (21.2%) and the least one was Child A. Hepatitis C (10.6%) was found to be associated with cholelithiasis (75.8%), followed by hepatitis B (13.6%). Auto-immune disease, diabetes mellitus, contraceptive pills and obesity are considered risk factors for cholelithiasis. Conclusion: Cholelithiasis tends to occur more frequently in patients with decompensated CLD. The higher incidence of cholelithiasis in CLD appears to be associated with HCV infection. This is an important parameter to be considered in a country with high prevalence of HCV as Egypt

Female space between social reality and subtraction dramatic

Background: This study aims at knowing the Female Space between social reality and subtraction dramaticit also aims to identify the relationship between social reality and subtraction dramatic quality of the spaces in the plays of the Egyptian writer Jacob Sharon and British writer Ted Hughes, The study used content analysis form, and compare the results statistically and then test the validity of the assumptions and the interpretation of results and the study found a set of results that the most important

Statistical Analysis Methods: z-test 2-chi-square

Results: The study validated the first and main hypothesis of the study, which states that: "There is a statistically significant relationship between the picture presented for the child in the plays and the image formed by the cultural heritage in a patriarchal society", study proved the health of the second hypothesis of the study,, which states that: "There is a statistically significant relationship between the marginalization of female roles within a patriarchal society and the marginalization of female roles in the play texts where the male child assume leadership roles in accordance with the provisions of the play of the study sample", proved to study the health of third hypothesis of the study, which states that: "There are significant differences between the social roles of child male differences female mother was in the play texts between the study sample and social roles in a patriarchal society in accordance with the provisions of the play of the study sample", and proved to study the health of fourth hypothesis of the study, which states that: "There are significant differences between the functional roles of the child zkra or female fa theatrical texts of the study sample and the functional roles of the child [male and female] in a patriarchal society in accordance with the provisions of the play of the study sample

Vocabulary development of down syndrome educable children using the video clip children songs

Introduction: Mental disability considers one of the human problems that most societies are suffering from, as it is not limited only on specific social level, but it also includes all economic and cultural levels, Down syndrome considers one of the basic pattern of mental disability characterized by mental shortness and poorness. Hence, it is necessary that we search in impact of using songs with children of Down syndrome who are educable and examine the extent those children songs help enriching those children language vocabulary

Problem: The study problem is defined in the following main inquiry "What is the effectiveness of using the video clip children songs in developing the educable children of Down syndrome language vocabulary?"

Significance: The study is beneficial for all those are dealing with children of Down syndrome, particularly parents, professionals, and trainers, helping them to select the appropriate songs that increase children vocabulary

Objectives: Identifying the most popular and effective children songs may acquire the Down syndrome children language vocabulary. Study Population and Sample: A sample of 30 Male/ Female children is selected from mental education schools in Cairo governorate, aged [6-12] year olds, divided into two equal groups, the control and the experimental

Tools: The Achievement Test [by researcher], and The video clip of Children Songs Program, for developing vocabulary [by researcher]

Results: Regarding the first hypothesis that says There are significant statistical differences between the control and the experimental group, in favor of the experimental group; denoting the effectiveness of the video clip children songs in developing vocabulary, Regarding the second hypothesis of study, the results demonstrate that no significant statistical differences exist between males and females post use of the video children songs with the down syndrome educable children

image of expatriate Egyptians presented in Arab movies and its relationship with mental image among adolescents

Problem: we can put the study problem in the following question: What is the image of expatriate Egyptians presented in Arab movies and its relationship with mental image among adolescents?

Aims: The present study essentially aims to identify the relation between the image of expatriate Egyptians presented in Arab movies and its relationship with mental image among adolescents, Identify the image of expatriate Egyptians presented in moviesx that carries different implications of alienation. Identify the extent of [positive or negative] image of expatriate Egyptians among adolescents who considered as first viewers of the movies, and Identify the type of problems which may face expatriate Egyptians according to study sample movies

Methods: The Study used the survey method by analytical sample

Sample: Program sample: I analyzed the movies which present the image of expatriate Egyptians froml/ 127 2013 to!5/ 2/ 2014

Tools: A content analysis form of films presented the image of expatriate Egyptiansprepared by the researcher

Results: The study movies that presented the image of expatriate Egyptians gave us positive image about them with a ratio of 70% and gave negative image with a ratio of 30%, The goal of entertainment and interestingness occupied the first position by 41.4% among the goals of study movies and showing positives and negatives of alienation occupied the second position by 24.2%, Expatriate Egyptians suffered from some difficulties in the study movies, these difficulties were difficulties of language with a ratio of 42.3% and difficulties of obtaining resident permission with a ratio of 19.3%, Foreign countries occupied the first position by 80% among the countries in which events of study movies took place and Arab countries occupied the second position by 20%, and The mam motivations of alienation are economic with ratio 46.6% and social with ratio 36.6%

role of some natural antioxidants in reducing the cytotoxic of cholesterol oxidized products [COPs] in rats exposed to H[2]O[2]

This study evaluated the effect of different types of antioxidants [selenium as sodium selenite, lyophilized green tea extract, lyophilized anthocyanins pigment of red grape mare extract, and lyophilized beta carotene pigment of carrot pulp waste extract] as antioxidants on the cytotoxic actions of oxysterols in plasma, brain and liver formed endogenously in rats exposed to H[2]O[2] [1 %], Rats were fed normal diet and exposed to H[2]O[2]-induced oxidative stress for 9 weeks. The concentrations of cholesterol oxidation products [COP] [25-hydroxycholesterol, 7 beta hydroxycholesterol and 7- ketocholesterol], were significantly increased in plasma and organs [brain and liver] in positive group, and significantly reduced by antioxidant treatment. Plasma· Malondialdehyde [MDA] and lactic acid dehydrogenase activity [LDH] were significantly increased, while the activity of superoxide dismutase [SOD] and catalase [CAT] activity were decreased in rats exposed to H[2]O[2] [1%]. The administrated antioxidants improved these values to the normal levels or near

Review: nutritional properties and benefits of the date fruits [phoenix dactylifera L.]

Phoenix dactylifera L. is known as the date palm. The Phoenix dactylifera L. is a monocotyledonous woody perennial belonging to the Arecaceae family. Fruits are rich sources of carbohydrates, dietary fibers, certain essential vitamins and minerals. Phytochemical investigations have revealed that the fruits contain anthocyanins, phenolic, sterols, carotenoids, procyanidins and flavonoids, compounds known to possess multiple beneficial effects. Date pits are also an excellent source of dietary fiber and contain considerable amounts of minerals, lipids and protein. In addition to its dietary use, the dates are of medicinal use and are used to treat a variety of ailments in the various traditional systems of medicine. Preclinical studies have shown that the date fruits possess free radical scavenging, antioxidant, ant mutagenic, antimicrobial, anti-inflammatory. gastro protective, hepatoprotective, nepbroprotective, anticancer and immunostimulant activities. Th.is review presents a comprehensive analysis of the photochemistry and validated pharmaco logical properties of date fruits and the seeds

Immunohistochemical localization of aipha-fetoprotein in liver of adult male albino rats treated with homocysteine and trimethylglycine

Alpha-fetoprotein[AFP] has been reported to be associated with hepatocellular carcinoma. Homocysteine [HCY] could be one of the factors contributing in elevating alpha-fetoprotein level in the rat liver. We aimed at investigating the effect of HCYon rat liver and studying the protective effect of Trimethyiglycine [TMG]. Adult albino rats were made hyperhomocystenamic by oral supplementation of 0.6mg/kg homocysteine compared to control and trimethylglycine 6gmlkg treated groups for 6 weeks of experimental duration. Liver was prepared for histopathological, histochemical studies. AFP was investigated by immunohistochemical techniques. Higher reaction of aipha-fetoprotein was observed in rat liver of HCY treated group rather than the interacting group, compared to-ye reaction in both control and TMG treated groups. Histopathological results of HCY treated rats revealed liver hepatocytes with cytoplasmic vacuolation and pyknotic nuclei. Dilatation of the central viens with interstitial haemorrhage and amyloid deposition were also observed. Kupfer cells and lymphocytes were both apparently increased. These changes were improved markedly with TMG administration. Histochemical localization for carbohydrates showed decrease reaction in hepatocytes of HCY treated group rather than other groups. It is concluded that HCY induced severe hepatic alterations. These alterations, were less prominent in animals treated with TMG indicating that TMG can be possible hepatoprotector against HCYinduced toxicity

[Study of the effectiveness of personal communication on developing the consciousness of protection skills from sexual abuse for mild mentally retarded children]

The research basically aims to study the effectiveness of the personal communication on developing the consciousness of protection skills from sexual abuse for mild mentally retarded children. The research depends on the experimental method, using [30] mentally retarded children, aged between [6-11] years and divided into two groups, one is an experimental and the other is a control one, each consists of [15] children. The tools of the research are: Good Enough- Harries Test for intelligence, [prepared by Good Enough- Harries]. The Data Collection Form for Social, Economical and Cultural Level, [prepared by Salah Mukhimer, 1979], a test for consciousness of protection skills from the sexual abuse for mild mentally retarded children, [prepared by the researcher] and a program for personal communication for developing the protection skills from sexual abuse for the mild mentally retarded children, [prepared by the researcher]. The most important result of the research is: There are statistically significant differences between the average grades of the experimental group before and after exposure to the program of the personal communication for developing the protection skills from sexual abuse for the mild mentally retarded children in favor of the after- test parameter. That is approved the effectiveness of this program which mentioned above

levels and characteristics of unemployment between the youth, [15-29] 2006

The rapid population growth and socio- economic changes greatly affect size of labour- force. The most important factors affecting the size of labour- force and unemployment is the population structure [age, sex, education and place of residence]. This study spots the light on the levels and characteristic of unemployment between the youth in the age groups [15-29 years]. 1- The rate of working population in the age group [15-29 years] in rural was more than that in urban and the rate of females workers of the age groups [15-29 years] is less than that of males. 2- The unemployment rate among population in age groups [15-19, 20-24, 25-29] increased in Urban [39%, 40%, 22%] compared with rural [23%, 24%, 13%] respectively, also the name pattern was observed among males and females, where females unemployment rate in the same age increased relative to that among male one in both urban and rural. 3- The rate of unemployment of females in the age groups, [15-29 years] is more than that of males in both urban and rural areas

Effect of homocysteine and protective role of trimethylglycine on the structure of tibia in growing albino rats: histological and biochemical study

Homocysteine [HCY] is an amino acid that is formed as an intermediate during the metabolism of methionine. Epidemiological studies have shown that too much homocysteine in blood plasma leads to a higher risk of coronary heart disease and strokes. It is also characteristic for homocystinuria. Trimethylglycine TMG [known as betaine] is a methyl donor that helps the quick conversion of homocysteine into methionine. Is to investigate the structural and the biochemical changes that occur in the articular cartilage, the growth plate and the bone structure of tibia in growing albino rats after being treated with oral supplement of HCY and possible protective role of TMG. Thirty two young male albino rats were used in this experiment. They were equally divided into four group. The control group received a balanced standard diet, HCY treated group received 0.6mg HCY/kg b.w/ day, TMG treated group [0.6gm TMG/kg b.w/day] and an interacting group received both HCY and TMG. Rats were sacrificed every 2 weeks up till the 8[th] week specimens from the tibias were obtained and processed for histological and biochemical study. Indicated that examination of rat bones of HCY group showed apparently abnormal radial and longitudinal bone growth. H and E stained sections of proximal ends of tibias showed changes in chondrocytes of proximal tibia. The growth plate of the proximal tibia showed a lack of the orderly chondrocytes columns arrangement. Examination of shafts of tibial bone of the same group showed many degenerative changes in periostum.The matrix contained many resorption cavities that were filled with granulation tissue. In addition there was evidence of abnormal biochemical patterns represented by low bone mineral density and bone mineral content. Statistically significant decrease in bone width compared to an increase in length and cross section area was detected. On the other hand TMG showed improved bone formation and inhibition of bone resorption. Was concluded that HCY produced profound histological changes in the articular cartilage, growth plate and bone structure of tibia of growing male albino rats. Mean while treatment with TMG markedly decreased the induced damage by HCY

Knowledge and practice of adolescent student girls regarding premenstrual syndrome

Premenstrual syndrome [PMS] refers to a cluster of physical, psychological and behavioral symptoms that occur during the Luteal phase of the menstrual cycle and end with the onset of menstruation. The very high prevalence of PMS might be related to lack of proper knowledge about menstruation and associated changes among girls. This study aims at evaluating the knowledge and practice of female students regarding premenstrual syndrome. A descriptive cross-sectional design was used in carrying out the study in four different general and technical governmental secondary schools for girls in Mansoura city. 600 student girls were selected through stratified random sampling, selecting, one general and one technical school from each zone. A structured interviewing questionnaire sheet, and modified version of menstrual distress questionnaire [MDQ] were used for data collection during period from 9/2005 to 3/ 2006, three days per week. Results: The results have shown that the mean age at menarche was 12.8 +/- 1.2 years, menstrual flow mean was 5.3j1.1 days, and 66.2% had regular cycles. The most prevalent premenstrual physical symptoms were backache [85.2%], and vaginal discharge [72.5%], while anxiety was the most common psychological symptom [72.2%]. Only 13% had severe PMS symptoms, and 14.8% had total satisfactory knowledge. Mothers were the main sources of information [73.8%]. The most common self- care practices to relieve PMS were bathing [75.5%], avoiding non- prescribed medications [64.5%], and taking hot drinks [535%]. The practice of physical exercise was only 16.2%. A higher percentage of students in general schools had satisfactory knowledge, compared to technical schools, 21.1% and 8.6%, respectively [p<0.001], and students with illiterate mothers had the lowest percentage of satisfactory knowledge [7.6%], compared to secondary and university education [18.9% and 18.0%, respectively], p=0.020. The highest level of satisfactory knowledge was associated with the mother as a Source of information [7.9%], p=0.015. It is concluded that female secondary school students in Mansoura suffer from mild PMS symptoms. They have a lack of knowledge about PMS, and their mothers were the main source of information. Knowledge was better in general schools girls, with educated and working mothers. It is recommended to conduct educational sessions discussing menstruation and related issues for mothers in outpatient clinics or schools. The school nurse role should be fostered

Role of sonohysterography in evaluation of abnormal uterine bleeding

Transvaginal ultrasound is an excellent method for imaging uterine abnormalities. However, evaluation of the uterine cavity is limited. Hysterosonography, an ultrasound technique in which the endometrial cavity is distended with saline, enables the radiologist to reliably distinguish focal from diffuse endometrial pathologic conditions Study Objective: To evaluate its diagnostic value in the evaluation of endometrial abnormalities, and correlating it to the histopathulogical examination to help determine its role in clinical decision making in patients with abnormal uterine bleeding. Prospective randomized study. Settings: El-Shatby Maternity Hospital, and Radiology department, Alexandria Main University Hospital. This study was carried on 30 married women of different age groups complaining of abnormal uterine bleeding. All patients were examined by transvaginal ultrasound, then hysterosonography by saline infusion, to be followed by a surgical intervention D and C, hysteroscopy, or hysterectomy for which the whole uterus or the biopsied lesion was sent for histopathological examination. Sonohysterography is far more superior than transvaginal ultrasound in diagnosing focal and diffuse endometrial lesions, which did match the final histopathological examination in 80% of cases. Hysterosonography has further enhanced the transvaginal examination of the uterine cavity. This can be used for further evaluation of the site, nature, and even reach a final diagnosis of the lesion yet it could not replace the histopathologic diagnosis, however it can help determine the best mode of the treatment, whether medical or surgical

Effect of antioxidants on rats fed on thermally oxidized oil [fried oil]

The aim of the present study is to investigate the effect of different concentration of antioxidants on oxidative stress in rats fed on an oxidized oil. Sunflower oil was submitted to fryer treatments at temperature between [180-190 °C] on intermittent periods for 24 hrs. The changes in chemical properties of frying oil compared to fresh sunflower oil were investigated. Data illustrate the presence of an increase in acid value, peroxide value, polymers and a decrease in iodine number. Fatty acids constituents of this tested oil were also investigated. Fifty-four rats weighing approximately 100 grams each were divided into nine groups, each group containing six rats. Groups S2 and S3 fed on diets containing oxidized oil [15%] and the other groups S4, S5, S6, S7, S8 and S9 fed on the same diet used in group S2 and supplemented with different concentration of antioxidants BHT [.02 gm/100gm oil], sodium selenite [1.5 mg / kg diet], beta-carotene [10 mg/200gm rat/day], anthocyanin [1.43mg/200gm rat/day], cinnamon essential oil [0.9 gm/100 gm oil] and clove essential oil [0.9 gm/100 gm oil] respectively. Rats fed oxidized oil [S2 and S3] had higher concentrations of cholesterol, LDL-cholesterol and triglycerides. Although, the concentration of total thyroxine in plasma of rats fed oxidized diet [S2 and S3] was higher than rats fed the oxidized oil and supplemented with different concentrations of antioxidants. The damage caused by the oxidized oil was revealed by a significantly rise in lactic acid dehydrogenase activity [LDH] and thiobarbituric acid reactive substances [TBARs] in plasma of rats in groups S2 and S3. Compared to other groups [S4, S5, S6, S7, S8 and S9]. On the other hand, BHT as synthetic antioxidant at 200 ppm induced significant decrease in TBARs and increase in the LDH activity and function [liver and kidney]. Microscopical examinations of thyroid gland, heart, liver and kidney tissues of rats treated with natural antioxidants had the histological characters as that of the control rats whilst, the treatment of BHT at 200 ppm altered the features of rat liver, kidney, thyroid gland and severely damaged rat heart tissues

Changes of ascorbic acid content in serum and suprarenal gland of albino rats after injection of snake venoms

LD50 doses of B. arietans, B. gabonica, D. polylepis, N. haje, N. nigricollis. O. cerastes and C. viper snake venoms caused a significant depletion of ascorbic acid in the suprarenal gland from 28.47 percent to 70.87 percent while the same doses of the different venoms showed no significant changes in the ascorbic acid content in rat serum