The impact of COVID 19 on air pollution levels and other environmental indicators - A case study of Egypt.

The outbreak of coronavirus disease (COVID-19) not only affected health and economics, but also its effect extended to include other aspects, such as the environment. Using Egypt as a case study, this paper presents the impact of COVID-19 pandemic on air pollution levels by studying nitrogen dioxide (NO2), ozone (O3), particulate matter represented in absorbing aerosol index (AAI), carbon monoxide (CO), and greenhouse gas (GHG) emissions. The paper also highlights the impact of COVID-19 pandemic on other environmental indicators including environmental noise, medical and municipal solid wastes. The paper presents the Egyptian COVID-19 story from its different angles including the development of confirmed COVID-19 cases, containment measures from the government, the impact on the country's economy and the national energy consumption so as to effectively evaluate the effect on both the air pollution levels and the other studied environmental indicators. For the other environmental indicators, a strong link was observed between COVID-19 lockdown and the reduction in environmental noise, beaches, surface and groundwater pollution. For environmental noise, this has been confirmed by officially governmental announcements which reported that the level of environmental noise in Egypt was reduced by about 75% during the lockdown period. On the other hand, there are some negative effects, including an increase in medical solid waste (from 70 to 300 ton/day), municipal solid waste, as well as a less efficient solid waste recycling process. For air pollution levels, the data were obtained from National Aeronautics and Space Administration (NASA) and European Space Agency satellite data sets. The data for the lockdown period in 2020 have been extracted and compared to the corresponding months in the selected baseline period (2015-2019) to identify the effect that the lockdown period had on the air pollution levels in Egypt with focus on Cairo and Alexandria governorates. It was found that the AAI decreased by about 30%, the NO2 decreased by 15 and 33% over Cairo and Alexandria governorates, respectively, and that the CO decreased by about 5% over both governorates. In addition, the GHG emissions in Egypt were reduced by at least 4% during the pandemic. In contrast, ozone levels increased by about 2% over Cairo and Alexandria governorates. It can be concluded that the implemented containment measures during COVID-19 pandemic had resulted in both positive and negative environmental impacts. The positive environmental impacts are not sustainable and deterioration on them is expected to occur after the lockdown as it was before the pandemic. Therefore, stricter laws must be enacted to protect the environment in Egypt.

Screening of Egyptian toddlers for autism spectrum disorder using an Arabic validated version of M-CHAT; report of a community-based study (Stage I).

BACKGROUND: Although there is a recommendation that toddlers be screened for Autism spectrum disorder (ASD) during their 18- and 24-month well-care child visits, diagnosis often occurs well after the child turns 4 years old. Such delayed diagnosis hinders the implementation of early intervention thus worsens the long-term prognosis of ASD. OBJECTIVE: The current community-based study in its stage I aimed at early screening of Egyptian toddlers for ASD using an Arabic validated version of Modified Checklist for Autism in Toddlers (M-CHAT). METHODOLOGY: A cross-sectional community-based descriptive study was carried out enrolling 5546 Egyptian toddlers. They were randomly recruited from those attending Primary Health Care Units in six Egyptian governorates with a fair representation of the urban, semi-urban, and rural Egyptian populations. An Arabic validated version of M-CHAT was used as a screening tool for ASD. RESULTS: The current study revealed failure of M-CHAT (suspected to have ASD and needs further evaluation) in 1320 out of the enrolled 5546 Egyptian toddlers (23.8%). CONCLUSION: M-CHAT as a screening tool for ASD has flagged a considerable percent of the enrolled toddlers that necessitates referral for further evaluation (stage II) to settle the diagnosis of ASD in the true positive cases. Perfecting the delicate balance between sensitivity and specificity for ASD screening tools is crucial in order not to miss early detection of ASD cases and at the same time, to avoid over-diagnosis with subsequent abuse of the limited healthcare resources in developing countries.

Rectus andominis myocutaneous flap: Analysis of 40 cases.

We present a series of 40 cases who underwent reconstructive procedures using rectus abdominis myocutaneous units. The transplanted tissue comprised superior pedicle (26 cases), inferior pedicle (11 cases), and as free muscle flap (3 cases). The application fell into three groups i.e.; 1. breast and chest wall reconstruction; 2. groin, genital, and trochanteric area; and 3. leg and heel ulcer. The results show that surgical dissection of flaps is relatively easy and has a wide range of applications that can be used for different surgical reconstructive problems. Surgical dissection has a low incidence of complication for flap viability as well as for donor site.