Circulating foot-and-mouth disease virus serotype A African-genotype IV in Egypt during 2022.

Background and Aim: Foot-and-mouth disease (FMD) virus causes continuous outbreaks, leading to serious economic consequences that affect animal productivity and restrict trade movement. The potential influence of the disease was due to the emergence of new strains or re-emergence of local strains with major antigenic variations due to genetic mutations. This study aims to evaluate circulating virus in samples collected from infected animals during an outbreak using antigenic characterization and identify whether there is an emergence of a new strain or mutation. Materials and Methods: Reverse-transcription polymerase chain reaction (RT-PCR) was used to screen 86 samples. Viral protein 1 (VP1) codon sequencing was performed. The virus was isolated from the samples inoculated on the baby-hamster kidney cell line and Enzyme-linked immunosorbent assay was performed for serotyping and antigen detection. Results: Based on the RT-PCR screening results, 10 positive samples were selected for sequencing. The sequences belonged to the FMD serotype A African topotype originating from the ancestor prototype Sudan/77, with which it shared 98.48% ± 1.2% similarity. The divergence with local isolates from 2020 was 9.3%. In addition, the sequences were 96.84% ± 1.01% and 95.84% ± 0.79% related to Egyptian-Damietta type 2016 and Sudanese-2018, respectively. Divergence with vaccinal strains ranged from 10% to 17%. Amino acid sequence analysis revealed that the isolates had variation in the most prominent antigenic regions (residues 35-75) and the immunogenic determinants of the G-H loop of VP1 (residues 100-146 and 161-175). Conclusion: The current isolates should be included in the locally produced vaccine to provide broader immunogenic coverage against serotype A African topotypes.

West Nile virus: The current situation in Egypt.

Background and Aim: Due to climatic changes, arthropod-borne viruses have become a global health concern. In Egypt, West Nile virus (WNV) was initially detected in humans in 1950 and then in 1951, 1954, 1968, and 1989. Although WNV infection has been recorded in numerous Middle Eastern countries, its prevalence among the equine population in Egypt is unknown. This study aimed to investigate the current situation of vector-borne WNV in Egypt, estimate its seroprevalence, and assess the associated risk factors. Materials and Methods: We screened 1100 sera samples and nasal swabs from the same equids, 156 mosquito pools, and 336 oropharyngeal and cloacal swabs from migratory birds for WNV. The sera were investigated for the presence of immunoglobulin G (IgG) and immunoglobulin M (IgM) against WNV-prE. Real-time reverse transcription-polymerase chain reaction was used to detect WNV RNA in the nasal swab samples, mosquito pools, and migratory birds' oropharyngeal and cloacal swabs. Results: The seroprevalence showed positive IgG in sera samples collected from different districts. The data showed that horses were 1.65-fold more susceptible than donkeys, with male being 1.45 times more susceptible than females. Moreover, the tested equids samples were divided into three groups based on their age: <5 years, 5-10 years, and >10 years. The 5-10-year group was 1.1 and 1.61 times more vulnerable to infection than the <5- and >10 year groups. All the sera samples were negative for IgM. The nasal swabs from equids, oropharyngeal and cloacal swabs from migratory birds, and mosquito samples tested negative for WNV by molecular detection. Conclusion: Based on the obtained data, we recommend that effective control programs should be implemented to enable epidemiological investigations and understand the current situation of WNV in Egypt.

First detection of emerging HoBi-like Pestivirus (BVD-3) among some persistently infected dairy cattle herds in Egypt.

Bovine viral diarrhoea virus (BVDV) is a serious veterinary health concern worldwide. We conducted this study to determine the prevalence of persistent infections (PI) and identify the current strain among some dairy cattle herds in Egypt. A total of 240 serum samples were collected from six Egyptian provinces. Between 2019 and 2020, samples were tested by Enzyme linked immunosorbent assay (ELISA) for detection of PI animals, and then molecular characterization was performed. Six calves were found PI with a prevalence of 2.5% (6/240). Using molecular characterization, HoBi-like Pestivirus (BVD-3) was successfully identified in Egypt for the first time. Based on the BVD-3 reference strains on Genbank, the detected strains had an identity ranging from 98.8 to 99.6%. Partial nucleotide sequence of the 5'UTR gene for six tested samples was submitted to Genbank with accessions: OM324396, OM324397, OM324398, OM324399, OM3243100, and OM3243101.

Enhancing performance of WDM-RoFSO communication system utilizing dual channel technique for 5G applications.

In this work, the performance of wavelength division multiplexing based radio over free space optics (WDM-RoFSO) communication system is investigated utilizing OptiSystem 0.7 software. Four weather conditions are adopted in this paper, namely, clear, haze, rain and fog with attenuation losses of 0.2 dB/km, 2.3 dB/km, 4.3 dB/km and 8 dB/km, respectively In addition, a high radio frequency of 30 GHz with high bit rate of 160 Gbps is modulated and carried on optical signal for fifth generation (5G) applications. The dual channel technique is employed in order to enhance the performance parameters of proposed WDM-RoFSO communication system. The enhancement in the link range is about; 46.1%, 35%, 29.4% and 25.9% for clear, haze, rain and fog, respectively.

Wideband full double-pass serial hybrid fiber amplifier utilizing L-shape configuration.

In this work, a new, to the best of our knowledge, full double-pass serial hybrid fiber amplifier is simulated on OptiSystem 7.0 software. A wideband flat gain spectrum covered both conventional and long communication bandwidth (C+L) from 1530 to 1590 nm, which is approximately 60 nm with high average gain of 23.6 dB; acceptable noise figure of 7 dB is achieved via the L-shape configuration. The main innovative step in the proposed design is decreasing the cascading amplification effect between the combined amplifiers, by making the individual full double-pass for the input signal in each amplifier stage.

Study on Precipitating Factor of Chronic Hepatic Encephalopathy.

Hepatic encephalopathy (HE) is a neuro-psychiatric manifestation of chronic liver disease causing significant morbidity and mortality worldwide. Though the exact mechanism is unknown but it is well accepted that various precipitating factors are involved in hepatic encephalopathy. Aim of the study was explore the precipitating factors of chronic hepatic encephalopathy. This cross sectional descriptive study was conducted in the Department of Medicine and Department of Hepatology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh during the period from April 2016 to October 2016. One hundred patients with hepatic encephalopathy fulfilling the inclusion and exclusion criteria were enrolled. Inclusion criteria were designed for all diagnosed cases of hepatic encephalopathy associated with cirrhosis of liver aged 18 years or above irrespective of sex. Patients with acute fulminant hepatitis and non-cirrhotic hepatic encephalopathy were excluded. The result of the study was mean age of hepatic encephalopathy was 52.81±8.15 years and 94.0% patients were above 40 years. Male (66.0%) were predominant over female (34.0%). HBsAg and Anti HCV were positive in 49.0% and 11.0% patients respectively. Stage of hepatic encephalopathy was stage-I in 8.0%, stage-II in 37.0%, stage-III in 39.0% and stage-IV in 16.0% patients. Changes of biochemical parameters were low haemoglobin level (70.0%), raised total count of leukocyte (25.0%), low platelet count (68.0%), low serum albumin (98.0%) raised prothrombin time (60.0%), low serum sodium (34.0%) and low serum potassium (63.0%). The recoded precipitating factors were gastrointestinal bleeding (14.0%), constipation (37.0%), hyponatremia (34.0%), hypokalemia (28.0%) infections (20.0%), use of diruretics (8.0%), use of sedatives (4.0%) and excess intake of protein (6.0%). While precipitating factor was absent in 11.0% of cases. In conclusion there are different factors which play a key role in precipitating hepatic encephalopathy but electrolytes imbalance, constipation, infections, Upper GI bleed, diuretics are the most common precipitating factors.

Early Functional Outcome of Wide Resection and Endoprosthesis Replacement for Recurrent Giant Cell Tumour of the Distal Femur.

Giant cell tumors (GCT) are usually benign bone tumors with aggressive characteristics. Giant cell tumors have a benign indolent course in most patients, but tumors may recur locally in as many as 50% of cases depending on the type of treatment and initial presentation of the tumor. The aim in the management of long bone GCT is to eradicate the tumor and prevent local recurrences. In this study, we retrospectively assessed the functional outcomes in 5 patients having recurrent GCTs of the distal femur treated with custom made modular endoprosthesis following wide resection of the tumor from January 2017 to December 2018 in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Tumor Society functional score (MSTS) was used to assess the results of our patients. The mean follow-up period was 13.2 months. We achieved good to excellent results with our mean functional score of 80.66%. To the best of our knowledge, probably first started by us using customized modularendoprosthetic massive replacements for recurrent GCTs in our country. The use of custom made modular mega prosthesis is a simple and technically superior method of feeling the bone defects after wide resection in aggressive recurrent GCTs. In our opinion endoprosthesis replacement for recurrent GCTs had early good to excellent functional results 5.

Anterior Cruciate Ligament Reconstruction Using Autologous Hamstring Double Bundle Graft Compared With Single Bundle Graft Procedures.

Anterior cruciate ligament injury is one of the commonest sports injuries, which often markedly reduces activity and the quality of life. The autologous hamstring double bundle graft and single bundle graft are commonly used for anterior cruciate ligament reconstruction. The choice of graft material for ACL reconstruction is believed to play a major role in the outcome but still there are controversies about the graft selection for primary ACL reconstruction. The aim of this study was to compare the clinical and functional outcome of autologous double bundle (DB) hamstring graft and single bundle (SB) hamstring graft reconstruction for the ACL injury. This prospective observational study was conducted in the Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from March 2015 to September 2017. Total 42 cases of ACL injury that required reconstruction surgery was selected as per inclusion criteria. Total patients were allocated into two groups. One group was treated by single bundle graft and other group was treated by double bundle graft for the ACL reconstruction. In this study, the mean age of double bundle and single bundle groups were 28±6.63 and 30.14±7.55 years respectively and majority of the subjects were male. The post-operative symptoms and signs were more improved in double bundle group than single bundle group during last follow-up period of 6th months. The Lachman test, Anterior drawer test and pivot sift test were more negative in double bundle group than that of single bundle groups. The Lysholm and Tegner activity were better in double bundle group than single bundle group. Again rotational and anterior stability of the knee was better in the double bundle group. However, the differences were not statistically significant and all patients in our study were able to return their activity. Double bundle group showed better rotational stability than the single bundle groups and all knees were improved by anterior cruciate ligament reconstruction compared with their pre-operative status.

Review of General Dental Council and General Medical Council "fitness to practise" hearings related to maxillofacial surgery.

Dually-registered specialists in oral and maxillofacial surgery (OMFS) may be subject to disciplinary hearings by the General Medical Council (GMC) and the General Dental Council (GDC) for the same allegations, a phenomenon referred to as "double jeopardy" within the specialty. Previous efforts by both councils to simplify regulatory arrangements have made little progress. We have therefore reviewed the range and scope of fitness to practise (FTP) proceedings relevant to OMFS. We searched the online GMC register to find registered OMFS specialists and obtained FTP proceedings from 2004-2016 through a Freedom of Information request from the GDC. We then searched for cases relevant to OMFS, and cross-checked GMC and GDC registers for dual registration before reviewing relevant cases and identifying and discussing themes. Seven OMFS specialists are currently subject to GMC sanctions. A total of 22 GDC hearings related to OMFS, all of which began after 2011. Six involved the practice of OMFS, work within an OMFS department, or work by a dually-registered doctor. While "double jeopardy" is uncommon, it does happen. The cases reviewed raise issues about the remit of the GDC and their understanding of clinical practice in OMFS. We found no evidence of progress in attempts to simplify FTP proceedings. The number of GDC hearings relevant to OMFS is increasing.

Correlation between Troponin-I and B-Type Natriuretic Peptide Level in Acute Myocardial Infarction Patients with Heart Failure.

Troponins are regarded as markers of choice for the diagnosis of acute myocardial infarction (AMI). But B-type natriuretic peptide (BNP) level is also elevated in AMI and is a quantitative biochemical marker related to the extent of infarction and the left ventricle systolic dysfunction. Thus, BNP has prognostic value. In this study, we investigate the correlation of Troponin-I with BNP levels in patients presenting with AMI with or without Acute Heart Failure. Rationale of this study is to see, whether quantitative Troponin alone can serve for both diagnosis and prognosis of AMI Patients with heart failure or not. This cross-sectional analytical study was conducted in the Department of Cardiology in Mymensingh Medical College Hospital from January 2014 to December 2014. Total 100 patients were studied and divided into two groups - 50 patients in each group. Group I: Patients with first attack of acute myocardial infarction (without heart failure) & Group II: Patients with first attack of acute myocardial infarction with acute heart failure. Mean Troponin-I of Group I and Group II were 3.10±2.68 and 62.93±32.75ng/ml respectively & mean BNP value of Group I and Group II were 20.96±14.18 and 615.65±249.27pg/ml respectively. In this study, it was shown that the levels of BNP had positive correlation with Troponin-I levels, with medium strength of association (r=0.734, p<0.05). Echocardiography shows that patients with high BNP level has low ejection fraction (LVEF) and patients with low BNP level has preserved ejection fraction (LVEF). Thus, the present study shows that the higher the Troponin-I levels, the higher the BNP levels in first attack of AMI patients and the more severe the heart failure (more severe left ventricle dysfunction). There is positive correlation between Troponin-I and BNP levels in first attack of AMI patients with acute heart failure.

Detection of asymmetric glaucomatous damage using automated pupillography, the swinging flashlight method and the magnified-assisted swinging flashlight method.

PURPOSE: To determine the sensitivity and specificity of various methods of detecting a relative afferent pupillary defect (RAPD) in patients with glaucoma-related diagnoses. PATIENTS AND METHODS: Patients underwent RAPD evaluation using the swinging flashlight method (SFM), the magnifier-assisted SFM, and pupillography using the Konan RAPDx. Main outcome measures were sensitivity and specificity of three methods of RAPD evaluation in detecting visual field mean deviation (MD), cup to disc ratio (CDR), disc damage likelihood scale (DDLS), and retinal nerve fiber layer (RNFL) asymmetry. RESULTS: Eighty-one consecutive patients from the Wills Eye Hospital glaucoma service were enrolled, 60 with glaucoma and 21 with ocular hypertension or glaucoma suspect. Thirty-one percent of subjects had MD asymmetry>5 dB, 19.7% had CDR asymmetry≥0.20, 26.7% had DDLS asymmetry≥2, and 38.2% had RNFL asymmetry>10 microns. Sensitivity values for pupillography were 93.3% (95% CI, 68.1-99.8) for detecting MD asymmetry, 80.0% (95% CI, 51.9-95.7) for CDR asymmetry, 100.0% (95% CI, 73.5-100.0) for DDLS asymmetry, and 69.2% (95% CI, 38.6-90.9) for RNFL asymmetry. Specificity values were 41.2% (95% CI, 24.7-59.3) for detecting MD asymmetry, 32.8% (95% CI, 21.3-46.0) for CDR asymmetry, 33.3% (95% CI, 18.0-51.8) for DDLS asymmetry, and 42.9% (95% CI, 21.8-66.0) for RNFL asymmetry. Pupillography amplitude score was correlated with MD asymmetry (r2=0.41, P<0.001) and area under the curve was 0.84. CONCLUSION: Automated pupillography had higher sensitivity and lower specificity in detecting MD, CDR, DDLS, and RNFL asymmetry. Within the bounds of the cohort tested, this method had limited case-finding ability.

Study of the risk factors and complications of diabetes mellitus after live kidney donation.

OBJECTIVES: Kidney donors, similar to the general population, are at risk for developing type 2 diabetes mellitus (T2DM). The course of donors who develop T2DM has not been well studied. This work estimates the incidence of diabetes after kidney donation, and some risk factors and complications of diabetes mellitus postdonation. MATERIALS AND METHODS: This study examined the records of 2267 donors who donated one of their kidneys between 1976 and 2014 at the Urology and Nephrology Center, Mansoura University, Egypt, and who were regularly followed up at its outpatient clinic. A total of 388 donors were included in the study, and their medical records were revised. RESULTS: Postdonation weight gain and family history of diabetes mellitus were statistically significant for the development of diabetes mellitus, high or very high albuminuria, and/or decreased creatinine clearance. Metformin and insulin use seemed to significantly reduce the protein excretion and creatinine clearance decline in the studied group. CONCLUSIONS: There is a significant impact of a family history of diabetes mellitus on the development of high or very high albuminuria and/or decreased creatinine clearance.

Characterization of degenerative human facet joints and facet joint capsular tissues.

OBJECTIVE: Lumbar facet joint degeneration (FJD) may be an important cause of low back pain (LBP) and sciatica. The goal of this study was to characterize cellular alterations of inflammatory factor expression and neovascularization in human degenerative facet joint capsular (FJC) tissue. These alterations in FJC tissues in pain stimulation were also assessed. DESIGN: FJs were obtained from consented patients undergoing spinal reconstruction surgery and cadaveric donors with no history of back pain. Histological analyses of the FJs were performed. Cytokine antibody array and quantitative real-time polymerase chain reaction (qPCR) were used to determine the production of inflammatory cytokines, and western blotting analyses (WB) were used to assay for cartilage-degrading enzymes and pain mediators. Ex vivo rat dorsal root ganglion (DRG) co-culture with human FJC tissues was also performed. RESULTS: Increased neovascularization, inflammatory cell infiltration, and pain-related axonal-promoting factors were observed in degenerative FJCs surgically obtained from symptomatic subjects. Increased VEGF, (NGF/TrkA), and sensory neuronal distribution were also detected in degenerative FJC tissues from subjects with LBP. qPCR and WB results demonstrated highly upregulated inflammatory cytokines, pain mediators, and cartilage-degrading enzymes in degenerative FJCs. Results from ex vivo co-culture of the DRG and FJC tissue demonstrated that degenerative FJCs increased the expression of inflammatory pain molecules in the sensory neurons. CONCLUSION: Degenerative FJCs possess greatly increased inflammatory and angiogenic features, suggesting that these factors play an important role in the progression of FJD and serve as a link between joint degeneration and neurological stimulation of afferent pain fibers.

Enhancing performance of multiwavelength Brillouin-Raman fiber laser by capturing residual pump power.

We demonstrate a simple design to enhance the performance of a multiwavelength Brillouin-Raman fiber laser by capturing the residual Raman pump power (RPP) from the laser cavity using a wavelength-selective coupler. The performance parameters of the laser system are investigated and compared with the conventional design under the same input design parameters. Both laser systems at a RPP of 375 mW can generate up to 33 Stokes lines with an equal channel spacing of 0.08 nm; however, the tunability of the laser without injection of residual RPP is 25% higher than the conventional laser structure. In addition, for a laser system without residual RPP injection, increasing the RPP improves the laser performance and generates up to 42 Stokes lines with a tunability of 24.5 nm, from 1570 to 1594.5 nm, at 475 mW. In contrast, the laser system with a residual RPP has the worst performance as the pump power is increased, and generates only nine Stokes lines with a tuning range of 5 nm at the same RPP of 475 mW.

Effectiveness of levofloxacin in enteric fever.

This intervention study was conducted to determine the efficacy of Levofloxacin in the treatment of uncomplicated enteric fever. Among 100 patients, who were purposively selected for the study had presented sign and symptoms of enteric fever with blood culture positive salmonella in laboratory findings during the admission in the department of Medicine, Uttara Adhunik Medical College & Hospital, Dhaka. Patients who fulfilled the diagnostic criteria were enrolled in the study and divided into two groups. One group was treated with oral levofloxacin 750mg once daily (OD) and another was injected with Levofloxacin 500mg once daily for 7 days. All the patients were examined twice daily to observe the clinical cure or failure of levofloxacin. Study was conducted from January 2008 to December 2008. Statistical analysis was performed by using statistical software SPSS version 12. Among the 100 patients in the study, majority of them 46(92%) were aged between 15 to 25 years, the next group was between 25 to 35 years 26(52%) and only three patients were aged above 65 years. Significant number of the patients were male (67), and the rest of them were female. The patients were clinically examined specially for anaemia, jaundice, caecal gurgling, hepatosplenomegaly in both the groups and the relevant investigations were performed. It was found that 46 patients in group A, who took oral levofloxacin, were cured after seven days, whereas 48 patients in group B were fully cured by taking injectable levofloxacin by seven days. In this study, levofloxacin was found to be the most effective drug in both oral and injectable form in one-week treatment of uncomplicated typhoid.

Epidemiological study of gastro-esophageal reflux disease in rural population.

The present survey was conducted to find out the prevalence of Gastro-Esophageal Reflux Disease (GERD) among rural population in Bangladesh. The survey was carried out between the periods of June and October 2005 in a defined population at Jangalia village of Gazipur district. All respondents were interviewed face-to-face at their home by using a structured questionnaire. Total 3948 respondents were interviewed and 3924 were included in the final analysis. Response rate was 87.73%. Among the respondents male and female were 2089(53.2%) and 1835(46.8%) respectively. Male: female ratio was 1:0.87. The mean±SD age was 33.74±15.52 years. The prevalence of heartburn for at least monthly, weekly and daily episodes was 17.8%, 12.1% and 2.7% respectively. The corresponding figures for acid regurgitation were 19.2%, 10.9% and 1.6% respectively. The prevalence of GERD, as defined by the presence of heartburn and/or acid regurgitation at least once weekly was 19.4%. Prevalence of GERD by scoring system using the questionnaire was 22.1%. The multivariate analysis revealed that the increasing prevalence of GERD in older age group (p>0.05; OR, 1.04; 95% CI 0.31-3.67), men (p>0.05; OR, 1.44; 95% CI, 0.89-2.36), with smoking habit (p<0.001; OR, 2.49; 95% CI, 1.94-3.20). Prevalence of GERD was significantly more in housewives (p<0.05; OR, 2.56; 95% CI, 1.80-3.63). This can be concluded from the present study that GERD is highly prevalent in the community.

Burnout among clinical dental students at Jordanian universities.

Dentistry is a profession demanding physical and mental efforts as well as people contact, which can result in burnout. The level of burnout among 307 clinical dental students in 2 Jordanian universities was evaluated using the Maslach Burnout Inventory survey. Scores for the inventory's 3 subscales were calculated and the mean values for the students' groups were computed separately. Dental students in both universities suffered high levels of emotional exhaustion and depersonalization. The dental students at the University of Jordan demonstrated a significantly higher level of emotional exhaustion than their counterparts at the Jordan University of Science and Technology.

Burnout among clinical dental students at Jordanian universities

Dentistry is a profession demanding physical and mental efforts as well as people contact, which can result in burnout. The level of burnout among 307 clinical dental students in 2 Jordanian universities was evaluated using the Maslach Burnout Inventory survey. Scores for the inventory's 3 subscales were calculated and the mean values for the students' groups were computed separately. Dental students in both universities suffered high levels of emotional exhaustion and depersonalization. The dental students at the University of Jordan demonstrated a significantly higher level of emotional exhaustion than their counterparts at the Jordan University of Science and Technology

Failure to implement hospital antimicrobial prescribing guidelines: a comparison of two UK academic centres.

BACKGROUND: Rational antimicrobial therapy should provide maximum benefit to patients while minimizing the development of resistant microorganisms. OBJECTIVES: The aim of this study was to investigate (i) which antimicrobial drugs were chosen by hospital doctors faced with two common infections [community-acquired pneumonia (CAP) and urinary tract infection (UTI)], (ii) whether these choices were compliant with local guidance and (iii) the factors that influenced antimicrobial choice. METHODS: A questionnaire based on two hypothetical clinical scenarios was distributed to 316 hospital doctors across four UK NHS hospitals in two cities (Newcastle and Edinburgh). RESULTS: Doctors in Newcastle were significantly more aggressive in their management: more patients were admitted (CAP: 78.9% versus 48.4%, P < 0.05) and given antimicrobials intravenously (CAP: 53.4% versus 21.2%, P < 0.05). Adherence to the local hospital guideline for CAP was significantly higher in Newcastle (83.3% versus 38.0%; P < 0.05). Fewer than half of the doctors surveyed used the local hospital guideline when choosing an antimicrobial, and the British National Formulary was the most frequently used resource (>90%). Junior doctors also identified medical school teaching and opinions of senior doctors as important influences. CONCLUSIONS: This study highlights inadequacies in the implementation and promotion of local guidelines, and demonstrates the potential for widely varying antimicrobial practices in two comparable UK cities.

An improved method for the palladium-catalyzed amination of aryl iodides.

Aryl iodides are coupled with amines to give the corresponding arylamines in high yield in the presence of palladium, a suitable ligand, and NaOt-Bu. Functionalized aryl iodides give good yields of the corresponding arylamines when Cs(2)CO(3) is substituted as the base.