Inter - Relationship of Awareness, Knowledge, Attitude, Some Socio-Economic Variables and Osteoporosis in Sample of Egyptian Women

BACKGROUND: Osteoporosis is a global health problem, and its prevalence is rapidly increasing worldwide. AIM: The aim was to assess the awareness concerning some nutritional and socio-economic variables causes the disease in a sample of Egyptian women. METHODS: This study was done among 116 female volunteers. They were divided into two groups, pre and post-menopausal, with a mean age of 42.05 ± 8.25 & 51.13 ± 5.82 years and mean body mass index (BMI) of 30.83 ± 8.18 & 34.24 ± 8.80 kg/m2. A standardised questionnaire, socioeconomic and food frequency chart were used to assess osteoporosis and food intake awareness. Bone mineral density was measured by dual-energy X-ray absorptiometry (DEXA). Statistical analyses were done using simple percentage and Chi-square test. RESULTS: Data revealed that a low percentage of pre and post-menopausal women were aware of osteoporosis and fracture (16.67% & 12.96% and 30.65% & 19.35%). They had incomplete knowledge about the sources and the beneficial effects of consumption of calcium and vitamin D rich diet. Non-osteoporotic women showed more awareness. Odds ratio predict occupations and educations levels as risk factors for osteoporosis. CONCLUSION: Awareness about osteoporosis and consumption healthy diet were low among Egyptian women, so it is important to implement special osteoporosis prevention program

Effect of Acupuncture on Body Weight Reduction and Inflammatory Mediators in Egyptian Obese Patients

AIM: Aim of this study was to examine the effectiveness of body acupuncture on body weight loss, routine laboratory tests and pro-inflammatory markers.METHODOLOGY: The study was performed on eighty obese patients. They were divided into three groups according to their body mass index. Subjects received acupuncture for three- six months in combination with a low-calorie diet. They were assessed pre and post acupuncture, by anthropometric measurement, routine laboratory tests and, tumor necrosis factor- alpha (TNF-α), interleukin- 6 (IL-6), and high sensitivity C-reactive protein (hsCRP) levels in serum.RESULTS: The pre-acupuncture results showed significant difference between the three grades of obesity and the controls regarding TNFα, IL-6 and hsCRP. We found significant reduction in anthropometric measurement of adiposity after acupuncture. In comparing the pre &post acupuncture results of TNF-α, IL-6 and hsCRP showed high significant reduction after acupuncture. There are highly significant decrease in kidney function (creatinine and uric acid) and lipid profile (cholesterol and triglycerides) and fasting blood glucose, but there was no significant difference in urea, SGPT, SGOT, HDL and LDL.CONCLUSION: Body acupuncture in combination with diet restriction was found to be effective for weight loss and also reduction of the inflammatory reactions. Acupuncture could be used as a synergistic treatment option for obesity control

Correlation Between Neutrophil-Lymphocyte Ratio, Platelets-Lymphocyte Ratio, and High-Resolution CT in Patients with COVID-19

Background: COVID-19 is a highly infectious disease that necessitates simple and rapid methods for recognising severe patients. Aims: To correlate between chest lesions in CT, neutrophil-lymphocyte ratio (NLR), and platelets-lymphocytes ratio in patients with COVID-19, and to detect their cut-off values as an early warning of severe COVID-19 in Egyptian patients. Subjects and Methods: A cross-sectional study included 100 adult patients with COVID-19 attending Ahmed Maher Teaching Hospital, Cairo, Egypt. Clinical, laboratory, and radiological assessments were done. They were classified according to their CT grades into three groups: seven patients with a normal chest CT, 45 non-severe cases, and 48 severe cases. Results: Dyspnoea was the most common symptom among the severe cases (79.2%) and fever among non-severe cases (71.1%), while cough (85.7%) was the most common among cases with a normal CT. The age, NLR, C-reactive protein (CRP), and D-dimer of severe cases were significantly the highest, while the absolute lymphocytes were significantly the lowest. Highly significant positive correlations were found between CT grades with D-dimer, NLR, and CRP; significant positive correlation was found with age; and significant negative correlation with CT. Using receiver operating characteristic analysis, areas under the curve of D-dimer, NLR, age, CRP, ferritin, and platelet-lymphocyte ratio were 0.760, 0.698, 0.640, 0.627, 0.614, and 0.595, respectively. The optimal cut-off value of NLR was 2.50 with 0.74 specificity, 0.61 sensitivity, and 67.5 accuracy. Conclusion: NLR is a reliable and easy-to-use predictor of COVID-19 severity. NLR (>2.5) should prompt prescription of a chest CT as it could reveal essential lesions that influence further management

Comparison of Three Protocols: Dietary Therapy and Physical Activity, Acupuncture, or Laser Acupuncture in Management of Obese Females

AIM: The aim of this study was to compare efficiency of three types of obesity management protocols: dietary measures and physical activity; acupuncture or laser acupuncture with   healthy diet among obese females.SUBJECTS AND METHODS: Randomized longitudinal prospective study, carried out on 76 adult females. Blood pressure, anthropometric, ultrasonographic and biochemical assessments were done.RESULTS: Females undergo nutritional intervention showed highly significant improvement in the anthropometric measurements, visceral fat at umbilicus by US and diastolic blood pressure (decreased), and insignificant differences in fasting blood sugar and lipid profile. Female undergo acupuncture intervention showed highly significant improvement in visceral fat by US, lipid profile (decreased triglycerides, total cholesterol and LDL, and increased HDL), and decreased fasting blood sugar, and insignificant differences in the anthropometric measurements. Those undergo laser intervention showed highly significant improvement in all anthropometric measurements under study, visceral fat at umbilicus by US, blood pressure and some parameters of lipid profile (decreased total cholesterol and LDL). CONCLUSIONS: Nutritional intervention alone could be used to reduce weight if the lipid profile within normal range, but if it is impaired, acupuncture should be used beside. To strength the reduction in body anthropometry, laser intervention was recommended beside the nutritional intervention

Body Composition Changes after Weight-Loss Interventions among Obese Females: A Comparison of Three Protocols

AIM: To evaluate body composition changes after use of three different types of obesity management protocols: dietary measures and physical activity; acupuncture or laser acupuncture with healthy diet; aiming at achieving stable weight loss among obese Egyptian females.METHODS:  A randomized longitudinal prospective study included 76 obese adult females; aged 26 up to 55 years. Anthropometric, body composition, ultrasonographic and biochemical assessments were done.RESULTS: The three types of obesity management protocols showed significant improvement in body composition (decrease in fat% and increases in FFM and TBW) and visceral fat by US. However, nutritional intervention showed highly significant improvement in the skin fold thickness at triceps and biceps sites and peripheral adiposity index.  Acupuncture intervention showed highly significant improvement in fasting blood glucose (decreased) and lipid profile (decreased triglycerides, total cholesterol and LDL, and increased HDL). Laser intervention showed highly significant improvement in all the skin fold thickness and some parameters of lipid profile (decreased total cholesterol and LDL). CONCLUSIONS: The three obesity management protocols have significant effect on body composition, but acupuncture has the best effect in improving the lipid profile and fasting blood sugar. In addition, Laser intervention was recommended to improve skin fold thickness and subcutaneous fat

Why do consumers trust online travel websites? Drivers and outcomes of consumer trust toward online travel websites

Egypt is currently one of the leading nations especially in the Middle East region with a well-established e-commerce environment and advanced IT infrastructure, but rapid growth of e-commerce will soon occur in other nations with similar consumption patterns. This study tests a model of antecedents (consumer experience, propensity to trust, reputation, perceived website size, ease of use, perceived usefulness, and website quality) and consequences of consumers’ trust toward online travel websites. Trust is expected to predict consumer attitude, perceived risk, and intention to purchase travel online. Data of 1,431 users of online travel websites were selected from the Supreme Council of Universities Database–Egypt (SCU) and analyzed through structural equation modeling. The findings show that all the aforementioned factors with the exception of consumer experience influence consumer trust toward online travel websites. Trust influences consumers’ attitude, perceived risk, and intention to purchase travel online

Neck Circumference as a Predictor of Adiposity among Healthy and Obese Children

BACKGROUND: Obesity, particularly in the upper part of body, is a major health problem. Because body mass index (BMI) does not adequately describe regional adiposity, other indices of body fatness are being explored.OBJECTIVES: To determine if neck circumference is a valid measure of adiposity (fat distribution) among group of Egyptian children.SUBJECTS AND METHODS: This is a cross sectional study, included 50 obese subjects, aged 7 - 12 years recruited from Endocrine, obesity and Metabolism Pediatric Unit at Children Hospital, Cairo University and 50 healthy children, age and sex matched. All children were subjected to blood pressure assessment (systolic SBP and diastolic DBP), and anthropometric assessment (body weight, height, neck circumference (NC), waist (WC) and hip (HC) circumferences, and skin fold thicknesses at three sites: biceps, triceps and sub scapular. BMI [weight (kg)/height (m2)] was calculated.RESULTS: In healthy females, significant associations were detected between NC and SBP, DBP and all anthropometric measurements. However, in healthy males NC was not significantly associated with BMI, SBP and DBP. In the obese group; both sexes; insignificant association was found between NC and SBP, DBP, BMI and skinfold thickness. CONCLUSION: NC is related to fat distribution among normal healthy female children. However, this relation disappears with increasing adiposity. The results do not support the use of NC as a useful screening tool for childhood obesity

WHS Guidelines for the Treatment of Pressure Ulcers: 2023 Update

The major populations at risk for developing pressure ulcers are older adults who have multiple risk factors that increase their vulnerability, people who are critically ill and those with spinal cord injury/disease. The reported prevalence of pressure ulcers in the United States is 2.5 million. However, this estimate is derived from acute care facilities and does not include people who are living at home or in nursing facilities. Despite the implementation of hospital and facility-based preventive measures, the incidence of pressure ulcers has not decreased in decades. In addition to the burden of pain, infection and death, it is estimated that hospital-acquired pressure ulcers cost the health system $26.8 billion annually with over 50% of the cost attributed to treating Stage 3 and 4 pressure injuries. Thus, it is critical to examine the literature and develop guidelines that will improve the outcomes of this complex and costly condition. This guideline update is a compendium of the best available evidence for the treatment of Pressure Ulcers published since the last update in 2015 and includes a new section based on changing demographics entitled ‘Palliative wound care for seriously ill patients with pressure ulcers’. The overall goal of the Wound Healing Society Guideline project is to present clear, concise and commercial free guidelines that clinicians can use to guide care, that researchers can use to develop studies that will improve treatment and that both clinicians and researchers can use to understand the gaps in our knowledge base

Assessment of the Anthelmintic Efficacy of Albendazole in School Children in Seven Countries Where Soil-Transmitted Helminths Are Endemic

Soil-transmitted helminths (roundworms, whipworms and hookworms) infect millions of children in (sub)tropical countries, resulting in malnutrition, growth stunting, intellectual retardation and cognitive deficits. Currently, there is a need to closely monitor anthelmintic drug efficacy and to develop standard operating procedures, as highlighted in a World Health Organization–World Bank meeting on “Monitoring of Drug Efficacy in Large Scale Treatment Programs for Human Helminthiasis” in Washington DC at the end of 2007. Therefore, we have evaluated the efficacy of a commonly used treatment against these parasitic infections in school children in Africa, Asia and South-America using a standardized protocol. In addition, different statistical approaches to analyzing the data were evaluated in order to develop standardized procedures for data analysis. The results demonstrate that the applied treatment was highly efficacious against round- and hookworms, but not against whipworms. However, there was large variation in efficacy across the different trials which warrants further attention. This study also provides new insights into the statistical analysis of efficacy data, which should be considered in future monitoring and evaluation studies of large scale anthelmintic treatment programs. Finally, our findings emphasize the need to update the World Health Organization recommended efficacy threshold for the treatment of STH

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely