Fear of COVID-19 and Its Impact on Job Satisfaction and Turnover Intention Among Egyptian Physicians

Materials and methods@#A cross-sectional study aimed to assess the prevalence of fear of COVID-19 among 411 frontline Egyptian physicians during the COVID-19 pandemic; identify determinants and predictors for fear of COVID-19; determine the impact of fear of COVID-19 on job satisfaction; and detect the impact of fear of COVID-19 on turnover intention. Three standardized scales (fear of COVID-19, job satisfaction, and turnover intention scores) were used for data collection via online Google Form. @*Results@#Regarding fear relating to the COVID-19 pandemic, 16.5% of the study subjects were classified as experiencing a severe fear level, while 78.1% experienced a moderate degree. A significant association between the level of fear relating to COVID-19 and the work department. The highest degree of fear is in a general-educational-university facility. Regarding job satisfaction, 42% of those having a severe level of fear are dissatisfied. Fear of COVID-19 is negatively associated with job satisfaction while positively significant correlated with turnover scores, a positive significant predictor of turnover intention. Job satisfaction is negatively associated with turnover intention; a negative significant predictor of turnover intention. @*Conclusions@#Frontline Egyptian physicians reported higher levels of fear relating to the COVID-19 pandemic (moderate to severe). Increased fear levels relating to COVID-19 have a relationship with lower levels of job satisfaction and higher levels of job turnover.

Novel PCR primers to diagnose visceral leishmaniasis using peripheral blood, spleen or bone marrow aspirates

OBJECTIVE@#To establish a suitable method of diagnosis of visceral leishmaniasis (VL) using peripheral blood, spleen or bone marrow aspirates.@*METHODS@#Peripheral blood, bone marrow and spleen aspirate samples were collected from clinically suspected VL patients (n = 26). A new PCR primer pair (MK1F/R) was designed targeting kinetoplast mini circle DNA sequences of Leishmania donovani, and Leishmania infantum, and was used to diagnose VL along with some other established primers for VL in polymerase chain reactions. Test was validated by comparing with several other diagnostic methods.@*RESULTS@#The designed primer set showed 100% specificity and 98% sensitivity in detecting VL using blood samples, when compared with more invasive samples: bone marrow or spleen aspirates.@*CONCLUSIONS@#The newly designed primer MK1F/R could be a better alternative for PCR based diagnosis of VL using less invasive sample, peripheral blood instead of bone marrow or spleen aspirates.

Novel PCR primers to diagnose visceral leishmaniasis using peripheral blood, spleen or bone marrow aspirates

Objective To establish a suitable method of diagnosis of visceral leishmaniasis (VL) using peripheral blood, spleen or bone marrow aspirates. Methods Peripheral blood, bone marrow and spleen aspirate samples were collected from clinically suspected VL patients (n = 26). A new PCR primer pair (MK1F/R) was designed targeting kinetoplast mini circle DNA sequences of Leishmania donovani, and Leishmania infantum, and was used to diagnose VL along with some other established primers for VL in polymerase chain reactions. Test was validated by comparing with several other diagnostic methods. Results The designed primer set showed 100% specificity and 98% sensitivity in detecting VL using blood samples, when compared with more invasive samples: bone marrow or spleen aspirates. Conclusions The newly designed primer MK1F/R could be a better alternative for PCR based diagnosis of VL using less invasive sample, peripheral blood instead of bone marrow or spleen aspirates.

Role of focused ultrasound in the diagnosis of acute appendicitis in pediatric population. selection of a standard diagnostic criterion

To evaluate the diagnostic role of focused ultrasound of right iliac fossa in clinically suspected cases of acute appendicitis in pediatric population and its value as a standard diagnostic tool in that age group. A retrospective, cohort study was conducted at radiology department of Agha Khan University involving 239 children less than 16 years with clinically suspected appendicitis referred to radiology department from January 2009 to October 2011 were included. Medical records were reviewed for patient demographics, presenting signs and symptoms, sonographic, surgical findings and histopathological results. Two hundred and thirty nine patients with clinical suspicion of appendicitis were referred for focused ultrasound for appendix. Ultrasound examination showed 59 cases [24.6%] positive for appendicitis and thus they were operated. All of these were positive on histopathology. The remaining 180 cases [75.4%] that were negative on U/S were managed conservatively. Out of these 180 cases, 13 patients with negative findings on imaging studies were later operated due to clinical decision and/or CT examination. Acute appendicitis was proven in 10 out of the 13 cases. Focused ultrasound has high sensitivity in acute appendicitis for the assessment of clinically equivocal cases of pediatrics population. It can be used as an initial screening modality especially in pediatric population, thus reducing additional cost and radiation risk associated with CT scans and also reducing rate of negative surgery

A Rare Presentation of Metachronous Multicentric Pelvic and Extracranial Chondrosarcoma: A Case Report

Conventional chondrosarcomas rarely metastasize and it is extremely unusual to see multicentric- behaviour in malignant cartilage tumour. We report a 40 year old lady with presentation of two non-contiguous metachronous foci of low to intermediate grade of chondrosarcoma over left pelvic bone and right scalp respectively in the absence of pulmonary or visceral metastasis.

Effect of retinoic acid on type I diabetes: Streptozotocin-induced rat model

To evaluate the effect of all trans retinoic acid [atRA] on differentiation/transdifferentiation of pancreatic duct/acinar cells into insulin secreting beta-cells in diabetic rats. 64 adult male rats divided into four groups. Normal control, diabetic control, atRA-I: diabetic rats treated with atRA [0.1 mg/kg/day, subcutaneously] and atRA-II: diabetic rats treated with atRA [2.5 mg/kg/day, subcutaneously] for 1, 2 and 4 weeks. The levels of glucose and insulin were measured. Histopathological, immunohistochemical examination of pancreas and RT-PCR of insulin mRNA were done. atRA led to an improvement in the level of glucose and insulin in both doses and at the different time points when compared with diabetic control. Histopathological examination of the pancreas revealed that atRA in both doses and at different time points nearly restored the normal appearance of the islets of Langerhans. Interestingly, some islets of Langerhans were found closely related to the interlobular ducts and the acinar epithelium. Mitotic figures were observed in the epithelium of the interlobular ducts and acinar cells and inside the islets of Langerhans especially with high dose. The immunohistochemical revealed strong insulin-immunoreactivity in the cytoplasm of the beta-cells and in the cytoplasm of the isolated cells which are closely related to the acini. Also, insulin mRNA expression showed dense band illumination similar to normal control. Retinoic acid may induced significant increase in insulin level and its mRNA, decrease glucose level and increased beta-cells regeneration through increased pancreatic duct and/or acinar cells differentian/transdifferentiation and increased proliferation of fbeta-cells in diabetic rats

Comparative Study Between Coaptive Film Versus Suture For Wound Closure After Long Bone Fracture Fixation

Background: Coaptive film (i.e., Steri-StripsTM) is an adhesive tape used to replace sutures in wound closure. The use of coaptive film for wound closure after long bone fracture fixation has not been well documented in the literature. Methods: The aim of this prospective, randomized controlled trial comparing coaptive film with sutures for wound closure after long bone fracture fixation was skin closure time, incidence of wound complications and scar width at 12 week follow-up. Forty-five patients underwent femur fracture fixation (22 patients’ wound closed with sutures, 23 with coaptive film). Results: The mean time for skin closure using coaptive film was 171.13 seconds compared to 437.27 seconds using suture. The mean wound lengths in the coaptive film group and suture group were 187.65 mm and 196.73 mm, respectively. One patient in each group had wound complications. Conclusion: Coaptive film is a time-saving procedure for skin closure following long bone fracture fixation. There is no difference in the incidence of wound complications and scar width between these two methods of skin closure.

Concurrent splenic lymphangiomatosis and Proteus syndrome

A 37-year-old female presented with Proteus syndrome and was found to have an asymptomatic enlarged spleen. Pathology confirmed splenic lymphangiomatosis. We describe an association of these 2 disorders in the Middle Eastern population. Diagnosis and pathogenesis are discussed in this case report

Efficacy of selected treadmill training programme on oxidative stress in adolescents with Down syndrome

The aim of this study was to assess the efficacy of an electronic treadmill exercise training programme on malondialdehyde [MDA] as a marker for lipid peroxidation and the antioxidant enzyme glutathione peroxidase [GPx] in adolescents with Down syndrome. The study was carried out on 30 adolescent males with Down syndrome, ranging in age from 15 to 18 years, with 30 healthy subjects as a control group. Clinical examination, anthropometric measurements and determination of GPx activity and MDA before and after exercise were done. A treadmill training programme was performed for 12 weeks. Our data showed a significant increase in GPx activity and decrease in serum level of MDA in Down syndrome individuals after treadmill exercise for 3 months. Exercise promotion for adolescents with Down syndrome requires attention to motivators and facilitators of exercise adherence as it may limit risk of increased neurological consequences associated with oxidative stress and improve quality of life

Accuracy of Two-Dimensional Speckle Tracking Echocardiography for the Detection of Significant Coronary Stenosis

BACKGROUND: Visual assessment of wall motion abnormalities (WMA) by 2-dimensional echocardiography (2DE) is the most semi-quantitative method used to detect coronary artery disease (CAD), but it carries many limitations. Speckle tracking echocardiography (STE) overcomes these limitations and allows an objective quantification of myocardial deformation. The aim of the study to examine the accuracy of global and segmental longitudinal strain (LS) for the detection of CAD compared with visual assessment of WMA using coronary angiography as a golden standard. METHODS: The study enrolled 25 patients (mean age 51.0 +/- 8.7, 64% are male) referred to coronary angiography with clinical suspicion of CAD. 2DE assessment of WMA and evaluation of LS using STE were performed using left ventricular 17-segments models. Significant CAD was defined as > or = 50% stenosis in one or more major coronary arteries by angiography. RESULTS: Patients were classified into 2 groups: group I included 15 patients with significant CAD and group II included 10 patients with insignificant and/or absence of CAD. WM score was strongly correlated with the global LS in group I and II (R = 0.80, p < 0.0001 and R = 0.88, p < 0.0001 respectively). In all patients, 425 segments were analyzed. WMA was detected in 163 segments of 425 (38.3%) while abnormal LS was detected in 214 segments (50.3%). Compared with coronary angiography, the total sensitivity, specificity and accuracy for visual analysis and STE were (56%, 88.2%, and 60% vs. 68.6%, 77%, and 81.8% respectively). CONCLUSION: Segmental LS is more accurate for the detection of ischemic myocardial segment corresponding to functionally relevant coronary anatomy than visual assessment of WM.

Evaluation of specific biochemical indicators of Helicobactepylori-associated gastric cancer in Egypt

The aim of the study was to assess the accuracy of some specific biochemical indicators in discriminating between Helicobacter pylori-associated gastritis and H. pylori-associated stomach cancer [serum gastrin level, serum soluble E-cadherin and tissue COX-2 activity, as well as serodiagnostic markers for H. pylori infection] in order to find a simple diagnostic test that can reasonably predict the development of gastric cancer. The study participants comprised 20 patients with gastric carcinoma, 20 patients with positive H. pylori-associated gastritis and 20 individuals as the control group. Standard procedures and quality control measures were followed. Using cut-off values and ROC analysis to assess the diagnostic abilities of the biochemical indicators, E-cadherin showed the highest sensitivity [100%]. We suggest that close follow-up together with periodic endoscopic examination for all patients with persistent H. pylori infection and serum soluble E-cadherin level above 5 microg/mL is essential

association of metabolic syndrome, insulin resistance and non-alcoholic fatty liver disease in overweight/obese children

To study the prevalence of metabolic syndrome [MS], insulin resistance [IR] and non-alcoholic fatty liver disease [NAFLD] in overweight/obese children with clinical hepatomegaly and/or raised alanine aminotransferase [ALT]. Thirty-three overweight and obese children, aged 2-13 years, presenting with hepatomegaly and/or raised ALT, were studied for the prevalence of MS, IR and NAFLD. Laboratory analysis included fasting blood glucose, serum insulin, serum triglycerides [TG], total cholesterol, high-density lipoprotein cholesterol [HDL-c], low-density lipoprotein cholesterol [LDL-c] and liver biochemical profile, in addition to liver ultrasound and liver biopsy. Twenty patients [60.6%] were labeled with MS. IR was present in 16 [48.4%]. Fifteen [44%] patients had biopsy-proven NAFLD. Patients with MS were more likely to have NAFLD by biopsy [P=0.001]. Children with NAFLD had significantly higher body mass index, waist circumference, ALT, total cholesterol, LDL-c, TG, fasting insulin, and lower HDL-c compared to patients with normal liver histology [P<0.05] and fitted more with the criteria of MS [80% vs. 44%]. IR was significantly more common among NAFLD patients [73% vs. 28%]. There is a close association between obesity, MS, IR and NAFLD. Obese children with clinical or biochemical hepatic abnormalities are prone to suffer from MS, IR and NAFLD

Supratrigonal vesicovaginal fistula repair by modified o'connor's technique using a free supporting graft

Background: A vesicovaginal fistula [VVF] is a surgical problem and is associated with many social consequences. Multiple techniques including different approaches and different tissues as interposition grafts have been proposed for the repair of the VVF. We are reporting our experience of VVF repair with free omental graft through transperitoneal transvesical approach

Objective: The objective of present study was to assess the outcome of supratrigonal vesicovaginal fistula repair by modified 0, connors' technique

Patients and Methods: This descriptive study was based on case series of nine patients of supratrigonal VVF admitted in surgical unit-1, between 1[st] December 2010 and 31[st] August 2011. After a detailed medical history, physical examination, per vaginal assessment, cystoscopy and radiological and laboratory work up these patients underwent VVF repair. Post operatively these were assessed for recovery, failure of fistula and development of any complications. Patients were re­ examined before discharge from hospital. Follow up visits were planned after 2 weeks and then after 3 months in order to assess success of repair

Results: Mean age of the patients was 37.5 +/- 11.7 years. Most of the patients [8] were from low socioeconomic group. Six patients had primary fistulae while 3 had recurrent. One patient had right ureteric dilatation due to iatrogenic ureteric ligation. The size offistulae noted during the surgery was < 2 cm in 5 patients and >2cm in 4 patients. Average operative time was 72 +/- 15 minutes. Average hospital stay was 9.4 +/- 3 days. Success rate was 100% as none of the repair failed. Minor urinary leakage, minimal hematuria and laparotomy wound infection settled spontaneously

Conclusion: Free omental graft through transabdominal transvesical approach for VVF repair is associated with very low morbidity and carries a very high success rate

Predictors of non-alcoholic fatty liver disease in obese and overweight Egyptian children: single center study

Pediatric non-alcoholic fatty liver disease [NAFLD] is a global problem which has been increasingly recognized with the dramatic rise in pediatric obesity. The aim of the present study was to identify the clinical, sonographic, and biochemical predictors for NAFLD in obese children. Seventy-six children [2-15 years] were included after an informed consent. All were subjected to full anthropometric assessment [including height, weight, body mass index, subscapular skin fold thickness, waist and hip circumference and calculation of waist: hip ratio], biochemical assessment of liver function tests, lipid profile and insulin: Sixteen patients [21%] had elevated ALT and 6 [7.9%] had elevated AST. Significant dyslipidemia [low HDL-c, high total cholesterol, high LDL-c and triglycerides] and higher insulin resistance were found in obese patients [P<0.01]. The main sonographic findings were hepatomegaly in 20 patients [26.3%] and echogenic liver in 41 patients [53.9%]. Liver biopsy showed simple steatosis in eight cases [24.2%] and non-alcoholic steatohepatitis [NASH] in seven cases [21.2%]. Anthropometric measurements, increased hepatic echogenicty by ultrasound, insulin resistance and lipid profile were good predictors of NAFLD in obese children if assessed together. However, LDL-c was the only sensitive predictor [independent variable] for NAFLD in both uni- and multivariate logistic regression analyses. Dyslipidemia per se is a strong predictor of NAFLD among obese Egyptian children

Genetic polymorphisms in non-alcoholic fatty liver disease in obese Egyptian children

Polymorphisms in the promoter of microsomal triglyceride transfer protein [MTP] lead to decreased MTP transcription, less export of triglyceride from hepatocytes, and greater intracellular triglyceride accumulation. Therefore, functional polymorphisms in MTP may be involved in determining susceptibility to nonalcoholic steatohepatitis [NASH]. The aim of this study is to examine the effect of some genetic influences among a group of obese Egyptian children. A cross-sectional study was conducted on 76 overweight and obese children presenting to the Pediatric Endocrinology Unit, Cairo University Children's Hospital, Egypt, as well as on 20 healthy controls. Anthropometric measurements were taken for all the patients and they underwent clinical examination, ultrasonographic examination of the liver, and liver biopsy when appropriate. Liver functions, blood glucose, serum insulin, C-peptide, and lipid profile were assessed and HOMA-IR calculated. Blood samples from biopsy-proven NASH patients and controls were analyzed by polymerase chain reaction [PCR] and restriction fragment length polymorphism for the -493 G/T polymorphism in the promoter of MTP and the 1183 T/C polymorphism in the mitochondrial targeting sequence of manganese superoxide dismutase [MnSOD]. Eight had biopsy-proven simple steatosis and 7 had NASH. NASH patients had a much higher incidence of the MTP G/G genotype [P = 0.002, CI: 2.9-392] compared with the controls. NASH patients also had a 100% prevalence of the MnSOD T/T genotype. Certain genotypes in MTP and MnSOD are significantly more prevalent among obese children with NASH and may be responsible for such a phenotype

biochemical and immunomodulatory effects of marbofloxacin in sheep vaccinated with live sheep pox vaccine

The study was performed to investigate the effect of marbofloxacin [2mg/kg body weight /day] on some immunological parameters in 9 sheep [35-40 kg. body weight] immunized with live attenuated sheep pox vaccine. Sheep were allocated into 3 equal groups. The first group was left as control; the second group was injected intramuscular [I/M] by marbofloxacin [2mg/kg body weight/day for 5 successive days] then vaccinated by intradermal [I/D] injection of 0.5 ml sheep pox vaccine/sheep. The third group was vaccinated with sheep pox vaccine only. The data revealed stimulation in the level of superoxide anion produced by neutrophil represented by detection of cytochrom C reduction level in the 2[nd] group [p<0.05] on the 1[st] day post vaccination, while there was significant depression in the level of lysozyme in the 1[st] two days post vaccination. The level of serum nitric oxide was not affected in the three groups. The lymphocytes transformation depressed significantly [p<0.05] in the 1[st] week post vaccination in the 2[nd] group as compared with the other two groups. It was concluded that marbofloxacin in its therapeutic level induced initial immunostimulant effect on the neutrophil followed by a transient immunosuppressive effect on other cells as macrophage when used before vaccination with live vaccine

Laser in situ keratomileusis for treated myopic anisometropic amblyopia in children

To evaluate the effects of laser in situ keratomileusis [LASIK] in decreasing myopic anisometropia in children with spectacles or contact lens intolerance and its validity in facilitating treatment of resultant myopic anisometropic amblyopia. LASIK was performed in 18 eyes of 18 children having myopic anisometropic amblyopia not successfully treated with the standard amblyopia treatment for 6 months. Children were followed up at 1 week, 1, 2, 6, 12, 18 and 24 months. Postoperative amblyopia therapy was continued with occlusion of the dominant eye for 6 h daily for the first 3 months and then for 4 h per day as long as possible. The mean spherical equivalent refraction in the operated eye had reduced significantly from -9.08 +/- 1.86D preoperatively to -0.97 +/- 1.16D at 2 years postoperatively. The mean spherical equivalent in the non-operated fellow eye was -1.0 +/- 1.15D preoperatively and -2.50 +/- 1.15D at 2 years. The mean spherical equivalent myopic anisometropia was -7.75 +/- 2.25D preoperatively and -0.50 +/- 0.3ID at 2 years, representing a 93.5% reduction in myopic anisometropia. The mean regression value was -2.28 +/- 1.62D, however, 18 eyes [72%] were within 3.OD of the fellow eye. The mean BCVA was significantly improved from 0.72 +/- 0.13 preoperatively to 0.47 +/- 0.17 by 2 years after LASIK with amblyopia treatment. LASIK is a safe and effective alternative method for correcting myopic anisometropic amblyopia, especially in children with spectacles or contact lens intolerance, with more better visual acuity and binocular vision

Effect of concommitant Helicobacter pylori infection in patients with Giardiasis lamblia in Egypt

Giardiasis is one of the most common enteroprotozoal diseases; its association with Helicobacter pylori is a common clinical finding. This work studied the impact of such association. Fifty giardiasis patients were classified into two groups according to the concomitant presence of H. pylori and ten normal healthy controls were also included. All patients were subjected to complete history taking, thorough clinical and stool examination, endoscopy, and biopsy of gastric and duodenal mucosa as well as histopatological examination. Results revealed significant upper gastrointestinal symptoms [epigastric pain and anorexia] in giardiasis patients with H. pylori. Also, endoscopic and histopathologic examination showed significant gastric lesions in this group of patients as compared to those suffering only G. lamblia