Irritable Bowel Syndrome and Inflammatory Bowel Disease: Is There a Link?

Abstract: Background: Symptoms of irritable bowel syndrome and inflammatory bowel disease can overlap. Whether irritable bowel syndrome can hide an organic disorder as inflammatory bowel disease is still questionable. We aimed to estimate the frequency of detection of inflammatory bowel disease in Egyptian patients with clinically diagnosed irritable bowel syndrome. Materials and Methods: We prospectively included 90 patients with clinically diagnosed irritable bowel syndrome according to Rome III criteria. For all included patients, complete blood count, erythrocyte sedimentation rate, C-reactive protein, stool analysis and stool culture were done. Besides these laboratory investigations, abdominal ultrasonography and colonoscopy with colonic biopsies were performed

Serum leptin level and microvascular complications in type 2 diabetes

Background. Type 2 diabetes (T2DM) and its complications are highly prevalent in Egypt and are considered a major health problem. Insulin resistance arising from visceral obesity is the main pathological mechanism of T2DM. Leptin is an adipokine secreted from visceral adipose tissue and its level is proved to be higher in patients with T2DM, but its association with microvascular complications is not yet well-established, for this aim the present study was conducted. Methods. This cross-sectional study was conducted among 120 participants with T2DM recruited from the diabetes outpatient clinic of Alexandria Main Uni­versity Hospital, Alexandria, Egypt. Each participant was subjected to full history taking, complete physical examination and laboratory investigations. Results. Serum leptin level was significantly positively correlated with diabetes duration, BMI, WC, systolic and diastolic blood pressure, FPG, HbA1c, serum insu­lin level, HOMA-IR, total cholesterol, triglycerides and LDL-C. Regarding microvascular complications, serum leptin level was highly significantly positively correlated with UACR, peripheral neuropathy and retinopathy (P < 0.001) and significantly negatively correlated with e-GFR (P = 0.003). Conclusions. Serum leptin level is significantly correlated with microvascular complications in patients with T2DM in Alexandria, Egypt

Gender Differences in Presentation, Management, and In-Hospital Outcomes for Patients with AMI in a Lower-Middle Income Country: Evidence from Egypt

BACKGROUND: Many studies in high-income countries have investigated gender differences in the care and outcomes of patients hospitalized with acute myocardial infarction (AMI). However, little evidence exists on gender differences among patients with AMI in lower-middle-income countries, where the proportion deaths stemming from cardiovascular disease is projected to increase dramatically. This study examines gender differences in patients in the lower-middle-income country of Egypt to determine if female patients with AMI have a different presentation, management, or outcome compared with men. METHODS AND FINDINGS: Using registry data collected over 18 months from 5 Egyptian hospitals, we considered 1204 patients (253 females, 951 males) with a confirmed diagnosis of AMI. We examined gender differences in initial presentation, clinical management, and in-hospital outcomes using t-tests and χ(2) tests. Additionally, we explored gender differences in in-hospital death using multivariate logistic regression to adjust for age and other differences in initial presentation. We found that women were older than men, had higher BMI, and were more likely to have hypertension, diabetes mellitus, dyslipidemia, heart failure, and atrial fibrillation. Women were less likely to receive aspirin upon admission (p<0.01) or aspirin or statins at discharge (p = 0.001 and p<0.05, respectively), although the magnitude of these differences was small. While unadjusted in-hospital mortality was significantly higher for women (OR: 2.10; 95% CI: 1.54 to 2.87), this difference did not persist in the fully adjusted model (OR: 1.18; 95% CI: 0.55 to 2.55). CONCLUSIONS: We found that female patients had a different profile than men at the time of presentation. Clinical management of men and women with AMI was similar, though there are small but significant differences in some areas. These gender differences did not translate into differences in in-hospital outcome, but highlight differences in quality of care and represent important opportunities for improvement

Politics with a conscience?: assessing the role of norm entrenchment in humanitarian (non-)intervention

This thesis deals with constructivist and English School accounts of humanitarian intervention. Literature from both of these schools contends that a "norm of humanitarian intervention" has emerged, whereby states should intervene to end massive human rights violations within other states. Accordingly, this thesis concerns itself with "norm entrenchment," the extent to which a norm has become sufficiently ingrained as to affect behavior. Specifically, this thesis examines the role played by norm entrenchment in bringing about US intervention and non-intervention in Somalia (1992-1993), Rwanda (1994), and Kosovo (1999). By assessing norm entrenchment at the individual, domestic, and international organization levels, this thesis concludes that norm entrenchment played little or no role in bringing about US intervention in Somalia and Kosovo, and non-intervention in Rwanda. Instead, these cases demonstrate that international organizations' credibility and maintenance enter into decisions to intervene or not to intervene in humanitarian crises.Cette thèse traite des théories relatives à la question des interventions humanitaires formulées par les constructivistes et par les représentants de l'Ecole Anglaise. La littérature des deux Ecoles affirme qu'une «norme relative aux interventions humanitaires» a émergé, selon laquelle les Etats devraient intervenir, afin de faire cesser les violations massives de droits de l'homme se déroulant à l'intérieur d'autres Etats. En conséquence, cette thèse traite «de l'établissement des normes», à savoir dans quelle mesure une norme est suffisamment enracinée pour affecter le comportement. Cette thèse examine en particulier le rôle joué par l'établissement de cette norme dans les interventions et les non-interventions des Etats-Unis en Somalie (1992-1993), au Rwanda (1994), et au Kosovo (1999). Par l'évaluation du processus de l'établissement d'une norme aux niveaux individuel, domestique, et à celui des organisations internationales, cette thèse conclut que l'établissement de cette norme n'a joué qu'un rôle insignifiant, voir inexistant dans l'intervention des Etats-Unis en Somalie et au Kosovo et leur non-intervention au Rwanda. Mais ces cas démontrent également que la crédibilité et la viabilité des organisations internationales sont des facteurs qui jouent un rôle dans la décision d'intervenir ou non dans les crises humanitaires. f

The use of Facebook as a customer engagement tool by newspapers in the UAE: an exploratory study

Social media has become very powerful nowadays as an easy way to approach, connect, share or exchange information all around the world. Many of the social media platforms like Facebook, Twitter and Instagram are being used as engaging and communication tools by corporations including newspapers. This is done to enhance the quality of services and to attain new customers. Facebook and other social media have also become the primary source of news for readers. Six local UAE Newspapers - Al Bayan, Al Emarat Al youm, Al Itihad, The Khaleej Times, The Gulf News and The National- have been analysed to find out the impacts of their Facebook pages on readers\u27 engagement. The findings confirm the importance of having a newspaper account on Facebook to positively impact customer engagement and increase ROI and brand awareness

Laboratory markers and radiological signs of mild versus severe COVID-19 patients

Background Coronavirus disease 2019 (COVID-19), a global pandemic that has spread worldwide in a dramatic manner since its first emergence in December 2019 from Wuhan, China. To date, there is still lack of an appropriate protocol that predicts cases who are impending to develop severe COVID-19. Hence, this work was an attempt to determine the potential association of the clinical, laboratory, and radiological parameters with the severity of COVID-19 and the ability of these parameters to predict the severe cases. Patients and methods This is a retrospective study that was based on recruiting the data from the files of patients who attended the chest outpatient clinic, or admitted to the chest department or the ICU of our institution. The study included adult patients who were diagnosed with COVID-19. Patients were categorized into two groups: severe/critical cases and mild/moderate disease cases. Data concerning the patient history, clinical picture, and radiological data were obtained and analyzed. Results Eighty adult patients with COVID-19 were included in this study. They were classified into severe/critical (40 patients) or mild/moderate disease (40 patients). Patients with severe/critical COVID-19 disease were significantly older in age and had higher comorbidities, prevalence, higher incidence of cough, dyspnea, gastrointestinal tract symptoms and fatigue, elevated total leukocyte count, lower relative lymphocytes, lower absolute lymphocytes and higher neutrophils, higher blood glucose levels, higher alanine transaminase, higher aspartate aminotransferase and lower serum albumin, reduced Ca levels, elevated lactate dehydrogenase, serum ferritin, D-dimer, and C-reactive protein levels. They had significantly higher computed tomographic (CT) scores and CT chest with greater than 50% lesions or progressive lesions. The mortality rate was 10%, all of which were from the severe disease group. Conclusion The current study is confirming an overall substantial association between severe COVID-19 and older age, chronic diseases, CT imaging pattern, and severity score, leukocyte count, lymphopenia, blood glucose, serum albumin, alanine transaminase, aspartate aminotransferase, calcium levels, C-reactive protein, D-dimer, lactate dehydrogenase, and ferritin. These results highlighted the importance of using clinical, laboratory, and radiological features for monitoring of COVID-19 patients

Comparison of GOLD classification and modified BODE index as staging systems of COPD

Objective: To compare GOLD classification of COPD versus the modified BODE index as staging systems of COPD. Background: Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation. The degree of airflow limitation was poorly predictive of dyspnea and quality of life. The BODE index was the first multidimensional assessment system for COPD. Cardiopulmonary exercise testing (CPET) is the most comprehensive, and correlates best with the symptoms of COPD. In this regard, two novel mBODE indices were constructed by replacing 6MWT with V̇O2 peak expressed either as the percentage of predicted values (mBODE%) or as the absolute values in ml/min/kg (mBODE). Methods: This study included 28 patients with a wide range of severities of COPD. Cardiopulmonary exercise test and pulmonary functions were done. GOLD spirometric staging and combined assessment grouping were calculated then compared with the two mBODE indices. Results: Moderate agreement between the GOLD combined assessment grouping and GOLD spirometric staging systems and between mBODE and mBODE% in stratifying severity of COPD patients was observed. Evaluation of mBODE index as predictors of severity of COPD using GOLD spirometric staging as a diagnostic predictor of COPD revealed that mBODE index was 100% sensitive. However, 59.1% and 72.2% specificity were found for mBODE V̇O2ml/min/kg and mBODE V̇O2% predicted, respectively. Conclusion: Multidimensional staging system taking into account the exercise pulmonary function tests is better than unidimensional systems based on the resting pulmonary function tests only. Therefore this suggests the need for integration of the novel multidimensional approach in the diagnostic guidelines of COPD