25 research outputs found
The Value of Serum Nestin in Monitoring the Effects of Surgery and Chemotherapy in Female Breast Cancer Patients: A Comparison with Serum CA15.3
Background: Traditional tumor markers such as cancer antigen 15.3 (CA15.3) and carcinoembryonic antigen (CEA) exhibit limited clinical utility in breast cancer due to their lack of sensitivity and specificity, particularly for detecting low-volume tumors. Other serum markers, such as nestin, may offer more promise. This study aimed to assess the clinical significance of serum nestin and CA15.3 in breast cancer patients.Method: This case-control study enrolled 80 normal control females and 80 females with breast cancer. Serum samples were collected from both control and breast cancer groups. The serum nestin and CA15.3 levels were measured in all samples using enzyme-linked immunosorbent assay (ELISA) kits.Results: The serum levels of nestin and CA15.3 were found to be significantly elevated in the breast cancer patient group compared with the control group. Preoperative serum nestin levels exceeding 9.9 ng/ml demonstrated a substantial odds ratio of 27 (confidence interval: 4.57-159.67; P = 0.0003). In receiver operating characteristic curve analysis, serum nestin exhibited the highest significant area under the curve at 85.2% (P < 0.001), followed by serum CA15.3 at 70% (P = 0.021). Post-surgery serum nestin levels significantly decreased compared with pre-surgery levels (P = 0.045).Conclusion: Serum nestin outperforms serum CA15.3 in diagnosing breast cancer patients. Elevated serum nestin levels may represent a significant risk factor for the development of breast cancer. Furthermore, serum nestin can monitor the effects of surgery, whereas none of the assessed biomarkers exhibit a significant role in monitoring the effects of chemotherapy on breast cancer patients
Psychological impact of COVID-19 on healthcare workers: cross-sectional analyses from 14 countries
Abstract
Background
Healthcare workers (HCWs) have been impacted psychologically due to their professional responsibilities over the prolonged era of the coronavirus disease 2019 (COVID-19) pandemic. The study aimed to identify the predictors of psychological distress, fear, and coping during the COVID-19 pandemic among HCWs.
Methods
A cross-sectional online survey was conducted among self-identified HCWs across 14 countries (12 from Asia and two from Africa). The Kessler Psychological Distress Scale, the Fear of COVID-19 Scale, and the Brief Resilient Coping Scale were used to assess the psychological distress, fear, and coping of HCWs, respectively.
Results
A total of 2447 HCWs participated; 36% were doctors, and 42% were nurses, with a mean age of 36 (±12) years, and 70% were females. Moderate to very-high psychological distress was prevalent in 67% of the HCWs; the lowest rate was reported in the United Arab Emirates (1%) and the highest in Indonesia (16%). The prevalence of high levels of fear was 20%; the lowest rate was reported in Libya (9%) and the highest in Egypt (32%). The prevalence of medium-to-high resilient coping was 63%; the lowest rate was reported in Libya (28%) and the highest in Syria (76%).
Conclusion
COVID-19 has augmented the psychological distress among HCWs. Factors identified in this study should be considered in managing the wellbeing of HCWs, who had been serving as the frontline drivers in managing the crisis successfully across all participating countries. Furthermore, interventions to address their psychological distress should be considered
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
Summary
Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally.
Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies
have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of
the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income
countries globally, and identified factors associated with mortality.
Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to
hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis,
exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a
minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical
status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary
intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause,
in-hospital mortality for all conditions combined and each condition individually, stratified by country income status.
We did a complete case analysis.
Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital
diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal
malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome
countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male.
Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3).
Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income
countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups).
Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome
countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries;
p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients
combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11],
p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20
[1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention
(ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety
checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed
(ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of
parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65
[0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality.
Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome,
middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will
be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger
than 5 years by 2030
Digital addiction in children with end-stage kidney disease on regular hemodialysis: a cross-sectional study
Abstract Background Chronic kidney disease has a detrimental impact on the overall quality of life (QoL) in children. The regular visits to doctors, prolonged reliance on medication, frequent hospital stays, and changes in their physical appearance increase their vulnerability to developing psychiatric problems and hinder their daily activities and social interactions, resulting in isolation, poor peer relations, and low self-esteem. These factors may compel these children to depend on digital media to find connections, regulate emotions, and cope with their illnesses. The study aims to determine the prevalence of electronic addiction among minors undergoing regular hemodialysis for end-stage kidney disease (ESKD) while simultaneously assessing their parental styles and psychological adaptation. A total of 60 subjects were enrolled in the study and divided into two groups. Group A: Thirty patients undergoing regular hemodialysis for ESKD. Group B: Thirty healthy subjects of matching age and sex. All the recruited participants were subjected to semi-structured clinical interviews according to our institute’s sheets, Child Behavior Checklist (CBCL), Digital Addiction Scale for Children (DASC), Parent Authority Questionnaire (PAQ), and Psychological Adaptation Scale. Results Patients patients had a significantly higher prevalence of digital addiction compared to healthy subjects, with an average score of (87.00 ± 21.23) in dialysis patients against (53.00 ± 25.20) in normal participants, demonstrating significant differences (p< 0.001). There was a significant correlation between the duration of dialysis treatment and the prevalence of digital addiction (r = -0.415, p-value = 0.023). A significant inverse correlation was found between digital addiction and the emotional subtype of the psychological adaption rating (r= -0.375, p= 0.041). Conclusion The findings revealed that dialysis patients have a higher incidence of digital addiction. Prolonged dialysis duration was significantly associated with increased digital addiction among patients
Outcome of surgical management of laparoscopic cholecystectomy (LC) – related major bile duct injuries
Leg elevation decreases the incidence of post-spinal hypotension in cesarean section: a randomized controlled trial
Abstract Background Maternal hypotension is a common complication after spinal anesthesia for cesarean section (CS). In this study we investigated the role of leg elevation (LE) as a method for prevention of post-spinal hypotension (PSH) for cesarean section. Methods One hundred and fifty full term parturients scheduled for CS were included in the study. Patients were randomized into two groups: Group LE (leg elevation group, n = 75) and group C (Control group, n = 75). Spinal block was performed in sitting position after administration of 10 mL/Kg Ringer’s lactate as fluid preload. After successful intrathecal injection of local anesthetic, Patients were positioned in the supine position. Leg elevation was performed for LE group directly after spinal anesthesia and maintained till skin incision. Intraoperative hemodynamic parameters (Arterial blood pressure and heart rate), intra-operative ephedrine consumption, incidence of PSH, and incidence of nausea and vomiting were reported. Results LE group showed lower incidence of PSH (34.7% Vs 58.7%, P = 0.005) compared to the control group. Arterial blood pressure was higher in the LE group compared to the control group in the first two readings after spinal block. Other readings showed comparable arterial blood pressure and heart rate values between both study groups; however, LE showed less ephedrine consumption (4.9 ± 7.8 mg Vs 10 ± 11 mg, P = 0.001). Conclusion LE performed immediately after spinal block reduced the incidence of PSH in parturients undergoing CS. Trial registration The study was registered at Pan African Clinical Trials Registry system on 5/10/2015 with trial number PACTR201510001295348
Burnout syndrome among physicians working in primary health care centers in Kuwait
Objective: The aim of the study was to reveal extent of burnout problem among primary care physicians and the socio-demographic factors affecting its occurrence. Methods: The target population included all physicians working in these two health regions in Kuwait. Two hundred physicians working in the primary health care units in the selected regions agreed to participate in the study. A specifically designed questionnaire for this research was derived from Maslach Burnout Inventory (BMI). It included four domains, namely emotional exhaustion, depersonalization, personal accomplishment, and involvement. In addition, socio-demographic and work characteristics of physicians were studied and their association with burnout domains was illustrated. Results: More than half the sample was females (56%), in the age group 30–49 (56.5%) and of non-Kuwait nationality (51%). Emotional exhaustion and depersonalization had lower percentage scores than the positive ones namely, personal accomplishment, and involvement. Physicians had a mean percent score of 37.1 + 29.0% on the emotional exhaustion domain, 21.0 + 22.9% on the depersonalization domain, 63.2 + 26.3% on the personal accomplishment domain, and 46.2 + 29.9% on the involvement domain. The four domains of MBI were associated only with some of the studied socio-demographic and job characteristics of the studied physicians. Nationality, place of work, job and income had a significant association with emotional exhaustion, depersonalization, and personal accomplishment domains. Conclusion: Burnout syndrome is relatively common among Kuwaiti physicians working at the primary care level. The syndrome is more common among non-Kuwaiti physicians, general practitioners, and those with lower income. There is a need for training the physicians about how to cope with stress at work. Keywords: Burnout, Physicians, Primary care center
Morphological and molecular approaches of the nematode parasite Desportesius invaginatus (Acuariidae) infecting the cattle egret Bubulcus ibis (Ardeidae)
Investigations on the parasites that infect migrating birds worldwide are ongoing. To identify the parasite species that infect ardeids, morphological and morphometric characteristics were used. A total of 20 Bubulcus ibis (Ardeidae) specimens were collected from the agricultural lands belonging to the Faculty of Agricultural at Cairo University, which were then examined for nematode parasites. Only one acuariid species, belonging to the Acuariidae family, has been identified, with a prevalence rate of 50Â % (10/20) among infected egrets. The Desportesius species isolated from the gizzard of the egret host is morphologically and morphometrically compatible with Desportesius invaginatus, which was previously identified from several Ciconiiformes hosts of Bubulcus ibis (Egypt, India, and Taiwan), Egretta garzetta (France), and Egretta rufescens (USA). Additionally, utilizing the partial small subunit ribosomal RNA (18S rRNA) gene sequence, maximum parsimony based on the Tamura-Nei model was used to infer the phylogeny of the recovered Desportesius species. The query sequences revealed 99.37Â % identity for the 18S (MW358651.1) of the previously mentioned D. invaginatus. In addition to clarifying several morphological features of D. invaginatus, this study also provided new DNA data for this species