Quality of life in dialysis versus kidney transplantation

Introduction: The compromised health-related quality of life (HRQOL) of patient with end-stage renal disease(ESRD) is now well documented. One of the main pointswhen treating patients with ESRD, whose cure is not arealistic goal, is maximizing functioning and well-being,which refer to the ability to perform various dailyactivities and functions and to more subjective internalstates such as symptoms and feelings.Aim: Is to study the difference in QOL between dialysispatients and living renal transplant recipients using SF-36 Health survey and factors affecting QOL.Setting and participant: Seventy patients were includedin our study 34 of them were males and 36 females. Theywere divided into 3groups: Group Ia: 30 hemodialysispatients of at least 6 months duration on dialysis, GroupIb: 10 continuous ambulatory peritoneal dialysis (CAPD)and Group II: 30 recipients of living renal transplants of? 6 months duration. SF-36 questionnaire was filled byall patients; it includes eight subscales which can also becombined into two component summary scores, Aphysical component summary PCS {general heath (GH),physical function (PF), role-physical (RP), bodily pain(BP)} and a mental component summary MCS {roleemotional(RE), vitality (VT), mental health (MH), andsocial function (MH)}. Data were analyzed from thisquestionnaire to determine the QOL for all patients andwere correlated also with clinical and laboratoryparameters.Results: Among hemodialysis patients, PCS, PF and VTparameters were better in young subjects and MH waspositively correlated with the hemoglobin level. Patientswithout co-morbid conditions had significantly betterQOL in PF and RP parameters. QOL was significantlybetter in employed than unemployed persons regardingPF, RP, VT, SF, GH and PCS. As regard CAPD patients without co-morbid conditions had significantly better QOL than those with co-morbid condition regarding RP, GH, SF and PCS. Among recipients of renal transplantation, there was a significant positive correlation between hemoglobin level and QOL parameters PCS, MCS, VT, SF and MH and a significant negative correlation between age of transplanted recipients and PF and VT was recorded. Finally in comparison of the three studied groups there was significant difference between the studied groups as regard PF parameter of SF-36 health survey which was higher in transplanted group than HD and CAPD.Conclusion: In hemodialysis patients the best quality of life was to males young aged with high hemoglobin level and no co-morbid conditions. In CAPD the best quality of life was to young aged and no co-morbid conditions. In renal transplant the best quality of life was to young age and high hemoglobin level. Finally there was no difference in QOL with three forms of renal replacement therapy

DESIGN, CONSTRUCTION AND PERFORMANCE EVALUATION OF AN ALMOND KERENEL EXTRACTION MACHINE

A low-cost Almond (Prunus dulcis) kernel extraction machine was locally designed, manufactured and evaluated. Kernel extraction by the machine was conducted by first crushing the nut, and then separating seeds from a shell. The performance of the developed machine was evaluated in terms of machine productivity, cracking efficiency, kernel breakage and specific energy requirements. The evaluation was conducted at roller speeds (ranging from 0.5 to 1 m/s), rollers clearance (ranging from 14 to 25 mm) and two different roller casing materials (rubber and metal mesh). Results revealed that the increase of the roller speed was found to increase the machine productivity. However, it caused a decrease in the kernel breakage, cracking efficiency, energy requirements and the extraction cost. At all levels of roller speeds and both casing materials, the clearance between rollers of 16 mm resulted in lowest values of energy requirement, extraction cost and highest values of machine productivity. On the other hand, the clearance between rollers of 14 mm resulted in the maximum values of cracking efficiency. The use of rubber casing was found to increase the machine productivity, cracking efficiency and decrease the kernel breakage, energy requirements and extraction cost. 

Measurement Equivalence of Rosenberg's Self-Esteem: Electronic versus Traditional Scale

هدفت الدراسة إلى المفاضلة بين البنية العامليه التوكيدية للصورة التقليدية والنسخة الالكترونية لمقياس تقدير الذات لـــ Rosenberg (1965). طبقتالدراسة على عينتين تم اختيارهما بطريقة عشوائية بسيطةأحدهما للصورة التقليدية بإجمالي160 طالب وطالبة من طلاب البكالوريوس والدراسات العليا بكلية التربية بالإسماعيلية بمتوسط عمري 23 عاماً وانحراف معياري 3.45 عاماً، بينماالصورة الالكترونية بإجمالى197 متطوعاً ومتطوعة من مستخدمي شبكات التواصل الاجتماعي (تويتر، فيسبوك، سناب شات) بمتوسط عمري 29.7 عاماً وانحراف معياري 2.13 عاماً. استخدم الباحثان المنهج السببي المقارن تصميم بين المجموعات والذي يختبر التكافؤ للصور المتعددة والمقارنة بين أداء الطلاب عليها باستخدام اختبار ت للعينات المستقلة. وأظهرت النتائج تفوق الصورة الالكترونية عن التقليدية في مؤشرات المطابقة وثبات ألفا لكرونباخ، كما أسفرت النتائج عن عدم تكافؤ الصورتين على مقياس روسنبرج لتقدير الذات. وقد اوصت الدراسة باستخدام الصور الإلكترونية للاختبارات بما تتمتع بهمن حتميه الاستجابة على جميع مفردات الاختبارات وبالتالي الحد من مشكلات التحليل الإحصائي.The study aimed as comparing the factor structure of traditional and Electronic Self-esteem scale. Random sample has been selected and consisted of (n=160) for traditional, (n=197) for Electronic scale. Causal Comparative design and between groups method have been used. The findings revealed that the electronic scale has over weighted the traditional one on the fitting indices and on Cronbach's Alpha reliability coefficient. Furthermore, the results have shown that the sample of electronic version overpassed on the performance on Rosenbergs' Self-esteem scale

Effect of Filler Metal on the Performance of 2205 Duplex Stainless Steel Weldments

The escalated concern in duplex stainless steels by industries is due to their best mechanical and corrosion resistance properties. In this work, the mechanical properties welding duplex stainless steel 2205 has studied. Joints were made using the GTAW process with different fillers: duplex ER 2209 and austenitic filler ER 312. There is a similarity in the microstructure which is obtained between with the duplex ER 2209 filler to the duplex 2205 base material, but the joints produced with the austenitic fillers cause a increase of the ferrite(δ) to austenite(γ) phase ratio. In order to evaluate the influence of the fillers on the weld, the mechanical properties by impact , tensile test and the hardness test. The phase imbalance produced for the different fillers causes variation of the mechanical properties. Without getting any detrimental changes in the mechanical properties, by using different filler metals, has addressed in this work .while, ER 312 had the advantage in hardness , tensile, impact test and ferrite percent

Single versus bilateral chordo-papillary apparatus preservation in mitral valve replacement: a hemodynamic study

Background: It has been postulated that disruption of the mitral valve apparatus at the time of mitral valve replacement (MVR) is a risk factor for postoperative ventricular dysfunction. The aim of this study was to evaluate the effect of single versus bilateral chordo-papillary preservation on the left ventricular function in comparison to no preservation. Methods: This study was conducted from 2015 to 2018 on sixty patients who had MVR. The patients were classified into group I included 20 patients who underwent MVR with complete excision of the subvalvular chordae and tips of papillary muscles, group II: included 20 patients who underwent MVR with preservation of posterior chordo-papillary apparatus, and group III: included 20 patients who underwent MVR with preservation of both posterior and anterior chordo-papillary apparatus. Results: There were 20 males (33.3%), and the mean age was 48.76± 8.91 years. Patients in group III were significantly older (37.15 ±4.92, 39.8 ± 5.49, and 57.25 ± 6.93 years in groups I, II, and III, respectively; p< 0.001). The left ventricular end-diastolic (5.40 ±0.34, 4.96 ± 0.43, and 4.44 ± 0.55 mm in group I, II and III, respectively, p<0.001) and end-systolic diameter (4.33 ±0.48, 3.58 ±0.43 and 3.20 ±0.43 mm in group I, II and III; respectively, p<0.001) were significantly reduced in partial and complete preservation groups after 6 months. Left ventricular ejection fraction improved in the bilateral preservation and partial preservation groups after 6 months (45.32 ±9.78, 56.79 ±10.14, and 56.60 ±11.68 % in groups I, II and III respectively, p<0.001). Mechanical ventilation was significantly longer in group I (24.10 ± 6.6, 16.80 ± 5.97, and 15.80 ± 5.24 hours in groups I, II and III, respectively, p<0.001) and the duration of ICU stay was significantly longer in group I (78.65 ± 15.32, 65.40 ± 14.21, and 60.20 ± 12.58 hours in groups I, II and III, respectively, p<0.001). Conclusion: Preservation of the annulo-papillary continuity may preserve left ventricular geometry and performance. Total preservation of chordae could be superior to partial preservation with better left ventricular remodeling and improvement in the left ventricular functions

Association of GH gene polymorphism with growth and semen traits in rabbits

[EN] Although growth hormone (GH) gene mutations are described in several species, the studies concerning their variabilities and associations with economic traits in rabbits are scarce, particularly associations with semen traits. A total of 149 rabbit bucks from five populations (V-line=36, Moshtohor line=28, APRI line=42, cross ½A½M=23, and Gabali=20) were used in the present study to identify polymorphism of c.-78 C>T single nucleotide polymorphism (SNP) of GH gene among these populations and to investigate the association of GH gene polymorphism with body weight (BW), daily weight gain (DG) and semen traits. DNA was extracted from blood samples for genotyping of c.-78 C>T SNP of GH gene based on polymerase chain reaction with the restriction fragment length polymorphism (PCR-RFLP) technique. The genetic diversity of SNP C>T of GH gene was assessed in terms of genotypic and allelic frequencies, effective number of alleles (Ne), observed (Ho) and expected (He) heterozygosity, Hardy-Weinberg equilibrium (HWE), reduction in heterozygosity due to inbreeding (FIS) and polymorphism information content (PIC). Three genotypes of TT, CC and TC of PCR product of 231 bp of GH gene were detected and all the populations were in HWE in terms of GH gene. The highest Ne was obtained for the Moshtohor line (1.978), while the lowest allelic numbers were obtained for V-line (1.715) and Gabali breed (1.800). The highest genotype frequency of GH gene was 0.48 in TT genotype of V-line, 0.21 in CC genotype of Moshtohor line, 0.67 and 0.56 in TC genotype of ½A½M and Gabali rabbits (P<0.05). The highest frequency for C allele was recorded by Moshtohor line (0.45) and the lowest frequency by Gabali (0.32). The genetic diversity scores for GH gene were intermediate (Ho=0.551, He=0.471, PIC=0.358). The values of Ho ranged from 0.444 in V-line to 0.667 in ½A½M cross, while the values of He were 0.425 in V-line and 0.508 in Moshtohor line. The values of PIC were moderate and ranged from 0.332 in V-line to 0.375 in M-line. The highest FIS was observed in Moshtohor line (0.042) and the lowest value was observed in ½A½M cross (–0.413). The CT genotype of GH gene showed the highest and significant values for body weights at 4, 8, 10 and 12 wk (542, 1131, 1465 and 1861 g) and daily gains at intervals of 4-6 and 8-10 wk (23.1 and 26.5 g). Additionally, the CT genotype recorded the highest and significant values for volume of ejaculate (1.1 mL), sperm motility (57.6%), live sperm (85.6%), normal sperm (93.1%) and sperm concentration in semen (611×106/mL), along with the lowest and significant values for dead sperms (14.4%) and abnormal sperms (6.9%).The authors are very grateful to the Central Laboratory of the Faculty of Veterinary Medicine, Benha University, Egypt for the help and support in molecular genetic analyses. This work was financially supported by the research project entitled “Genetic improvement of local rabbit breeds by using molecular genetic techniques” from the Scientific Research Fund (SRF), Benha University, Egypt.Khalil, MHE.; Zaghloul, AR.; Iraqi, MM.; El Nagar, AG.; Ramadan, SI. (2021). Association of GH gene polymorphism with growth and semen traits in rabbits. World Rabbit Science. 29(1):31-40. https://doi.org/10.4995/wrs.2021.13001OJS3140291Abdel-Kafy E., Hussein B., Abdel-Ghany S., El-Din A., Badawi Y. 2015. Single nucleotide polymorphisms in growth hormone gene are associated with some performance traits in rabbit. Int. J. Biol. Pharm. Allied Sci., 4: 490-504.Afshari K.P., Javanmard A., Asadzadeh N., Sadeghipanah H., Masomi H., Sabrivand A. 2011. Association between GH encoding gene polymorphism and semen characteristics in Iranian Holstein bulls. Afr. J. Biotechnol., 10: 882-886.Alvariño J. 2000. Reproductive performance of male rabbits. In Proc.: 7th World Rabbit Congress, 4-7 July, Valencia, Spain.Amalianingsih T., Brahmantiyo B. 2014. The variability of growth hormone gene associated with ultrasound imaging of longissimus dorsi muscle and perirenal fat in rabbits. Media Peternakan, 37: 1-7. https://doi.org/10.5398/medpet.2014.37.1.1Amiri S., Jemmali B., Ferchichi M. A., Jeljeli H., Boulbaba R., Ben Gara A. 2018. Assessment of growth hormone gene polymorphism effects on reproductive traits in Holstein dairy cattle in Tunisia. Arch. Anim. Breed., 61: 481-489. https://doi.org/10.5194/aab-61-481-2018Bindu, K., Raveendran, A., Antony, S., Raghunandanan, K. 2011. Association of myostatin gene (MSTN ) polymorphism with economic traits in rabbits. In: Fibre production in South American Camelids and other fibre animals. Springer. https://doi.org/10.3920/978-90-8686-727-1_16Darwish S.F., Tarek S.H., Badr M.R. 2016. Association between genotypes of growth hormone gene and semen quality traits in cow bulls and buffalo bulls. Alex. J. Vet. Sci., 49: 147-152. https://doi.org/10.5455/ajvs.221998El-Aksher, S.H., Sherif, H.S., Khalil, M.H., El-Garhy, H.A.S., Ramadan, S. 2017. Molecular analysis of a new synthetic rabbit line and their parental populations using microsatellite and SNP markers. Gene Rep., 8: 17-23.https://doi.org/10.1016/j.genrep.2017.05.001El-Sabrout K., Aggag S. 2017a. Associations between single nucleotide polymorphisms in multiple candidate genes and body weight in rabbits, Vet. World, 10: 136-139. https://doi.org/10.14202/vetworld.2017.136-139El-Sabrout K., Aggag S. 2017b. The gene expression of weaning age and its effect on productive performance of rabbits. World Rabbit Sci., 25: 1-7. https://doi.org/10.4995/wrs.2017.4777El-Tarabany M.S., El-Bayomi K., Abdelhamid T. 2015. Semen characteristics of purebred and crossbred male rabbits. PloS one, 10: e0128435. https://doi.org/10.1371/journal.pone.0128435Estany J., Baselga M., Blasco A., Camacho J. 1989. Mixed model methodology for the estimation of genetic response to selection in litter size of rabbits. Lives. Prod. Sci., 21: 67-75. https://doi.org/10.1016/0301-6226(89)90021-3Fontanesi L., Tazzoli M., Scotti E., Russo V. 2008. Analysis of candidate genes for meat production traits in domestic rabbit breeds. In Proc.: 9th World Rabbit Congress, 10-13 June 2008,.Verona, Italy.Fontanesi L., Dall'Olio S., Spaccapaniccia E., Scotti E., Fornasini D., Frabetti A.. 2012. A single nucleotide polymorphism in the rabbit growth hormone (GH1) gene is associated with market weight in a commercial rabbit population. Livest. Sci., 147: 84-88. https://doi.org/10.1016/j.livsci.2012.04.006Gencheva D., Georgieva S., Velikov K., Koynarski T., Tanchev S. 2017. Single nucleotide polymorphism of the Growth Hormone Receptor (GHR) encoding gene in Oryctolagus cuniculus. J. BioSci. Biotechnol. 6: 197-201.Gidenne T., Garreau H., Drouilhet L., Aubert C., Maertens L. 2017. Improving feed efficiency in rabbit production, A review on nutritional, technico-economical, genetic and environmental aspects. Anim. Feed Sci. Technol., 225: 109-122. https://doi.org/10.1016/j.anifeedsci.2017.01.016Groeneveld E. 2006. PEST user's manual. Institute of Animal Husbandry and Animal Behaviour, Mariensee, Germany, FAL, Germany.Hristova D., Tanchev S., Velikov K., Gonchev P., Georgieva S. 2017. Rabbit growth hormone and myostatin gene polymorphisms. J. Agric. Res., 2: 000133 (Open Access). https://doi.org/10.23880/OAJAR-16000133Hristova D.G., Tanchev S., Velikov K., Gonchev P., Georgieva S. 2018. Single nucleotide polymorphism of the growth hormone (GH) encoding gene in inbred and outbred domestic rabbits. World Rabbit Sci., 26: 49-55. https://doi.org/10.4995/wrs.2018.7211Iraqi M., Afifi E., Baselga M., Khalil M., García M. 2008. Additive and heterotic components for post-weaning growth traits in a crossing project of V-line with Gabali rabbits in Egypt. In Proc.: 9th World Rabbit Congress, 10-13 June 2008, Verona, Italy.Kalinowski, S.T., Taper, M.L., Marshall, T.C. 2007. Revising how the computer program CERVUS accommodates genotyping error increases success in paternity assignment. Molecular Ecology, 16: 1099-1106. https://doi.org/10.1111/j.1365-294X.2007.03089.xKhalil M., Baselga M. 2002. Rabbit genetic resources in Mediterranean countries. In M. H. Khalil & M. Baselga (Eds.), Options Méditerranéennes (Vol. Série B, pp. 262). Zaragoza, Spain: CIHEAM-IAMZ.Khalil M.H., Al-Sobayil K., Al-Saef A., García M., Baselga M. 2007. Genetic evaluation for semen characteristics in a crossbreeding project involving Saudi and Spanish V-line rabbits. Animal, 1: 923-928. https://doi.org/10.1017/S1751731107000341Kmieć M., Terman A., Wierzbicki H., Zych S. 2007. Association of GH gene polymorphism with semen parameters of boars. Acta Vet. Brno., 76: 41-46. https://doi.org/10.2754/avb200776010041Lavara R., García M., Torres C., Vicente J., Baselga M. 2008. Genetic parameters for semen traits of rabbit males: II. Motility. In Proc.: 9th World Rabbit Congress., 10-13 June 2008, Verona, Italy.Lavara, R., Vicente, J., Baselga, M. 2011. Genetic parameter estimates for semen production traits and growth rate of a paternal rabbit line. J. Anim. Breed. Genet., 128: 44-51. https://doi.org/10.1111/j.1439-0388.2010.00889.xLavara, R., David, I., Moce, E., Baselga, M., Vicente, J. 2013. Environmental and male variation factors of freezability in rabbit semen. Theriogenology, 79: 582-589. https://doi.org/10.1016/j.theriogenology.2012.11.007Maertens L., Gidenne T. 2016. Feed efficiency in rabbit production: nutritional, technico-economical and environmental aspects. In Proc.: 11th World Rabbit Congress, 15-18 June, Qingdao, China.Migdal L., Palka S., Kmiecik M., Derewicka O. 2019. Association of polymorphisms in the GH and GHR genes with growth and carcass traits in rabbits (Oryctolagus cuniculus). Czech J. Anim. Sci., 64: 255-264. https://doi.org/10.17221/27/2019-CJASNikbin S., Panandam J.M., Yaakub H., Murugaiyah M. 2018. Association of novel SNPs in gonadotropin genes with sperm quality traits of Boer goats and Boer crosses. J. Applied Anim. Res., 46: 459-466. https://doi.org/10.1080/09712119.2017.1336441Pal A., Chakravarty A.K., Chatterjee P.N. 2014. Polymorphism of growth hormone gene and its association with seminal and sexual behavioral traits in crossbred cattle. Theriogenology, 81: 474-480. https://doi.org/10.1016/j.theriogenology.2013.11.002Peakall P., Smouse R. 2012. GenAlEx 6.5: Genetic analysis in Excel. Population genetic software for teaching and research. An update. Bioinformatics, 28: 2537-2539. https://doi.org/10.1093/bioinformatics/bts460Raymond M. 1995. GENEPOP (version 1.2): Population Genetics Software for exact tests and ecumenicism. J. Hered., 86: 248-249. https://doi.org/10.1093/oxfordjournals.jhered.a111573Sahwan F.M., El-Sheik A.I., Sharaf M.M., El-Nahas A.F. 2014. Genetic polymorphism in growth hormone receptor gene (GHR) and its relationship with growth trait in pure and hybrid rabbit breeds. Alex. J. Vet. Sci., 43: 45-51. https://doi.org/10.5455/ajvs.165197Tanchev S. 2015. Conservation of genetic resources of autochthonous domestic livestock breeds in Bulgaria. A review. Bulgarian J. Agric. Sci., 21: 1262-1271.Tusell L., Legarra A., García-Tomás M., Rafel O., Ramon J., Piles M. 2012. Genetic basis of semen traits and their relationship with growth rate in rabbits. J. Anim. Sci. 90: 1385-1397. https://doi.org/10.2527/jas.2011-4165Yardibi H., Hosturk G.T., Paya I., Kaygisiz F., Ciftioglu G., Mengi A., Oztabak K. 2009. Associations of growth hormone gene polymorphisms with milk production traits in South Anatolian and East Anatolian red cattle. J. Anim. Vet. Adv. 8: 1040-1044. https://doi.org/10.3923/javaa.2009.1040.1044Youssef Y., Iraqi M., El-Raffa A., Afifi E., Khalil M., García M., et al. 2008. A joint project to synthesize new lines of rabbits in Egypt and Saudi Arabia: emphasis for results and prospects. In Proc.: 9th World Rabbit Congress, 10-13 June, Verona-Italy.Zachmann M. 1992. Interrelations between growth hormone and sex hormones: physiology and therapeutic consequences. Horm. Res. Paediat., 38: 1-8. https://doi.org/10.1159/000182562Zhang W.X., Zhang G.W., Peng J., Lai S.J. 2012. The polymorphism of GHR gene associated with the growth and carcass traits in three rabbit breeds. In Proc.: 10th World Rabbit Congress, Sharm El-Sheikh, Egypt, 75-7

Assessment of the Extent of Myocardial Injury in Patients Undergoing Transvenous Implantation of a Pacemaker Using Cardiac Troponin I as a Marker of Structural Heart Damage and Its Relation to Different Sites of RV Implantation

Background and Aim: This study aimed to evaluate the degree of myocardial injury that occurs after transvenous pacemaker implantation using cardiac troponin I (cTnI) as a myocardial injury marker and the relationship between the number of screws, different sites of right ventricle (RV) lead implantation, and myocardial injury. Materials and Methods: Fifty patients at Ain Shams University Hospitals who underwent transvenous implantation of single- or dual-chamber permanent pacemakers were included in the study. According to the site of RV lead implantation, the study population was divided into 2 equal groups, 25 patients each. In the first group, the RV lead was implanted in the RV apex and in the other group, the RV lead was implanted in the RV septum. Results: In all patients, the cTnI level was elevated after pacemaker implantation, showing a significant relationship between transvenous pacemaker implantation and the incidence of myocardial injury. Comparing the RV apical pacing group with the RV septal pacing group, a greater rise in cTnI was recognized in the septal RV pacing group, indicating a significant relationship between the site of RV lead implantation and the degree of myocardial injury being more in the RV septum than in the RV apex. Moreover, the higher the number of attempts of screwing the lead in different RV sites caused more rise in cTnI, denoting a significant relationship between the number of screwing attempts and the extent of myocardial injury. Conclusion: Transvenous pacemaker implantation is associated with an increased incidence of myocardial injury, and septal RV lead implantation is associated with a higher degree of myocardial injury than apical RV lead implantation. In addition, a higher number of screwing attempts of the RV lead into the myocardium is associated with a higher degree of myocardial injury

A multifaceted risk model of brucellosis at the human-animal interface in Egypt

Brucellosis is a highly contagious zoonosis affecting humans and a wide range of domesticated and wild animal species. An important element for effective disease containment is to improve knowledge, attitudes and practices (KAP) of afflicted communities. This study aimed to assess the KAP related to brucellosis at the human‐animal interface in an endemic area of Egypt and to identify the risk factors for human infection. A matched case‐control study was conducted at the central fever hospitals located in six governorates in northen Egypt. Face‐to‐face interviews with cases and controls were conducted using a structured questionnaire. In total, 40.7% of the participants owned farm animals in their households. The overall mean practice score regarding animal husbandry, processing and consumption of milk and dairy products was significantly lower among cases compared to controls [‐12.7±18.1 vs 0.68±14.2 respectively; p< 0.001]. Perceived barriers for notification of animal infection/abortion were predominate among cases and positively correlated with participants’ education. The predictors of having brucellosis infection were consumption of unpasteurized milk or raw dairy products and practicing animal husbandry. Applying protective measures against infection significantly reduced its risk. A model predicting risk factors for brucellosis among those who own animal showed that frequent abortions per animal increased the chance for brucellosis infection among human cases by 50‐fold (95% CI: 8.8 – 276.9), whereas the use of protective measures in animal care reduced the odds [OR= 0.11 (95% CI: 0.03 – 0.45)]. In conclusion, consumption of unprocessed dairy products was equally important as contact with infected/aborted animals as major risk factors for Brucella spp. infection among humans in Egypt. There is poor knowledge, negative attitudes and risky behaviors among villagers which can perpetuate the risk of brucellosis transmission at the human‐animal interface. This supports the need for integrating health education into the national brucellosis control program

Biopiracy <i>versus </i>one-world medicine – from colonial relicts to global collaborative concepts

Background: Practices of biopiracy to use genetic resources and indigenous knowledge by Western companies without benefit-sharing of those, who generated the traditional knowledge, can be understood as form of neocolonialism.Hypothesis: : The One-World Medicine concept attempts to merge the best of traditional medicine from developing countries and conventional Western medicine for the sake of patients around the globe.Study design: Based on literature searches in several databases, a concept paper has been written. Legislative initiatives of the United Nations culminated in the Nagoya protocol aim to protect traditional knowledge and regulate benefit-sharing with indigenous communities. The European community adopted the Nagoya protocol, and the corresponding regulations will be implemented into national legislation among the member states. Despite pleasing progress, infrastructural problems of the health care systems in developing countries still remain. Current approaches to secure primary health care offer only fragmentary solutions at best. Conventional medicine from industrialized countries cannot be afforded by the impoverished population in the Third World. Confronted with exploding costs, even health systems in Western countries are endangered to burst. Complementary and alternative medicine (CAM) is popular among the general public in industrialized countries, although the efficacy is not sufficiently proven according to the standards of evidence-based medicine. CAM is often available without prescription as over-the-counter products with non-calculated risks concerning erroneous self-medication and safety/toxicity issues. The concept of integrative medicine attempts to combine holistic CAM approaches with evidence-based principles of conventional medicine.Conclusion: To realize the concept of One-World Medicine, a number of standards have to be set to assure safety, efficacy and applicability of traditional medicine, e.g. sustainable production and quality control of herbal products, performance of placebo-controlled, double-blind, randomized clinical trials, phytovigilance, as well as education of health professionals and patients

Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

BACKGROUND: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide. METHODS: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters. RESULTS: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 per cent of patients (2901 of 4223). Major complication rates (Clavien–Dindo grade at least IIIa) were 24, 18, and 27 per cent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 per cent; however, it was 41 per cent in low-to-middle- compared with 19 per cent in very high-HDI countries. CONCLUSION: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761