Temporal and spatial variations of surface water quality in the Nile River of Damietta Region, Egypt.

Temporal/spatial variations of surface water quality were examined for the Nile River in the Damietta region where it serves as the major source of water for the inhabitants of Damietta Governorate. A total of 32 water quality parameters were monitored at six sampling sites for 12 months from February 2016 to January 2017. Higher values of chemical oxygen demand (COD), biological oxygen demand (BOD), heavy metals, and nutrients were observed upstream. About ~ 70% of the total variance in observations was explained by five main influences using factor analysis. The first factor (24.6% of the variance) was indicative of the mixed sources of natural and anthropogenic inputs. The second (nutritional) and the third (organic) factors were mainly controlled by the discharges from agricultural and domestic sources, respectively. Human activities and natural processes controlled the fourth and fifth factors. Only 11 parameters (K, temperature, COD, HPC, total hardness, DO, NO2, Na, TDS, Cl, and EC) were necessary for distinguishing temporal variations according to Discriminant analysis (DA). Seven parameters (BOD, PO4, SiO3, Al, Turbidity, Fe, and Chlorophyll-a) were the most important variables responsible for spatial variations. Using the results we developed a water quality index (WQI) using only those parameters identified as important. All water quality parameters were below the permissible limits except for turbidity according to the World Health Organization standards, BOD and COD according to the Egyptian regulations. The calculated WQI values ranged between 12.73 and 33.73. According to these values, the Nile River Damietta branch represents a good to an excellent source of drinking water for entering secondary treatment.

Screening for hepatocellular carcinoma by Egyptian physicians.

AIM: To assess the practice of Egyptian physicians in screening patients for hepatocellular carcinoma (HCC). METHODS: The study included 154 physicians from all over Egypt caring for patients at risk for HCC. The study was based on a questionnaire with 20 items. Each questionnaire consisted of two parts: (1) personal information regarding the physician (name, age, specialty and type of health care setting); and (2) professional experience in the care of patients at risk for HCC development (screening, knowledge about the cause and natural course of liver diseases and HCC risk). RESULTS: Sixty-eight percent of doctors with an MD degree, 48% of doctors with a master degree or a diploma and 40% of doctors with a Bachelor of Medicine, Bachelor of Surgery certificate considered the hepatitis C virus (HCV) genotype as risk factor for HCC development (P < 0.05). Ninety percent of physicians specialized in tropical medicine, internal medicine or gastroenterology and 67% of physicians in other specialties advise patients to undergo screening for HCV and hepatitis B virus infection as well as liver cirrhosis (P < 0.05). Eighty-six percent of doctors in University Hospitals and 69% of Ministry of Health (MOH) doctors consider HCV infection as the leading cause of HCC in Egypt (P < 0.05). Seventy-two percent of doctors with an MD degree, 55% of doctors with a master degree or a diploma, 56% of doctors with an MBBCH certificate, 74% of doctors in University Hospitals and 46% of MOH hospital doctors consider abdominal ultrasonography as the most important investigation in HCC screening (P < 0.05). Sixty-five percent of physicians in tropical medicine, internal medicine or gastroenterology and 37% of physicians in other specialties recommend as HCC screening interval of 3 mo (P < 0.05). Seventy-one percent of doctors with an MD degree, 50% of doctors with a master degree or diploma and 60% of doctors with an MBBCH certificate follow the same recommendation. CONCLUSION: In Egypt, physicians specialized in tropical medicine, internal medicine or gastroenterology with an MD degree and working in a University Hospital are best informed about HCC.