Farā’id Alfāẓ al-Ḥayawānāt fī Al-Qur’ān Al-Karīm: Dirāsah fī al-I‘jāz al-Lugawi wa al-Bayāni

The Qur’an has many miraculous aspects, about which there has been much talk in the past and the present. It is related to the rhetorical and linguistic aspects, and this research comes as one of these episodes that reveal the secret of the uniqueness of the words of the Holy Qur’an in general and the uniqueness of its words in particular, which came in an unprecedented manner and was organized in a non-repetitive way between the folds of its verses, so it was distinguished and unique in that it was not repeated, even its root as well. So it was consistent with the splendor of its presentation and organized in its context, in a tight linguistic system from a wise expert, and to be specific, the research was limited only to the unique words of animals and insects that were mentioned in the entire Qur’an, using the integrative approach that mixes the historical method that traces the phenomenon to the origin of its origin, and from the first to launch it and use it through the times to what it has now settled, and the linguistic analytical method, which is useful in analyzing words linguistically to understand the meaning, then the descriptive method, which monitors the characteristics of the phenomenon and its features, then clarifying this uniqueness, its rhetorical effects, and its aesthetic value. Its graphic secret is a purely artistic work that falls under the artistic method. Accordingly, the study came in three main sections and a conclusion, accompanied by the sources and references of the research. The first of them: the definition of the uniques linguistically and idiomatically, the second: the uniqueness in the critical and rhetorical heritage, and the third: the uniqueness of animals and insects in the Qur’an. Perhaps with this we add a new twist to Qur’anic studies, in fulfillment of the Qur’an, and in enriching its language

Farāʾid Alfāẓ An-nābaāt fī al-Qurʾān al-Karīm: Dirāsaẗ fī al-‘iʿjāz al-Luġhowiy Wā At-Tarbiyah Al-Islaamiyah

This research is reveal the secrecy of the plant's sentences in the Qur'an, both specific and general aspects as it has not been previously revealed. This in-depth study in uncovering this uniqueness presents beauty because it is not repeated, and has root words so that it can be seen clearly the beauty of the presentation and arranged according to the context of the study is a clear linguistic system for those who understand. In addition to this linguistic beauty, the usefulness of this study also has meaning from the philosophical aspect of living life which can be used as a life lesson in the form of the value of life. This research is descriptive phenomenological research that uses an integrative approach and linguistic analysis by combining historical methods that explore phenomena both from the aspect of the word origin and the depth of meaning from the philosophical aspect of education. This research consists of two parts, namely the linguistic and philosophical aspects of Islamic education. From the linguistic aspect, there are three studies, namely the definition of linguistic and idiomatic characteristics, critical and rhetorical inheritance, and the uniqueness of plants in the Qur'an. Meanwhile, from the philosophical aspect of education, it is to explore the beauty of God's creation and make it an example in human life that provides many benefits to the surrounding environment. The results of the study conclude that ‎the study of plants in the Qur'an has diverse characteristics which are extremely beautiful in enriching language ‎scholarship and having a philosophical value from the living ways of plants that ‎ give benefits. The Qur'an has many unique characteristics, both historically and in contemporary reality. One of the uniqueness is the linguistic and rhetorical aspects of the word plant. The development of plants that provide many benefits to the surrounding nature can be imitated by humans as intelligent beings

Rare Mucinous Colorectal Adenocarcinoma: Analysis of the Epidemiological Factors in Relation to Survival in Egyptian Patients

Colorectal carcinoma (CRC) is one of the leading causes of cancer related deaths; in Egypt it constitutes 6.5% of all cancers. Previous studies have shown conflicting results on clinicohistopathological features and survival of patients with colorectal mucinous (MA) and non-mucinous adenocarcinoma (NMA). To the best of our knowledge, this study is the first to investigate these features in Egypt. In this work, we studied tumor tissue specimens from 150 patients with colorectal MA and NMA who underwent radical surgery from Jan 2007 to Jan 2012 at Gastroenterology Centre, Mansoura University, Egypt. Their clinicohistopathological parameters and survival were analyzed using established statistical methodologies. Incidence of MA and its subtypes was much higher in Egypt than worldwide incidence. MA was significantly associated with younger age, more depth of invasion, lymph node metastasis, less microscopic abscess formation and less peri-tumoral lymphocytic response (Crohn-like response) than NMA. Both groups were not significantly different "among others" in other clinicopathological parameters including lymphovascular and perineural invasion, association with adenoma and schistosomiasis. Multivariate analyses for disease free and overall survival revealed that mucinous histology is an independent prognostic factor. Among several factors, only distant metastasis and presentation with recurrent disease were independent prognostic factors within MA patients. In conclusion, MA represents a distinct clinicopathological entity with worse survival than NMA. Distant metastasis and presentation with recurrent disease are independent prognostic factors. Further molecular investigations considering genetic features of MA will lead to drug development and better management

Relationship between obesity, physical activity, sleeping hours and red blood cell parameters in adult Sudanese population: Effect of exercise and sleep hours on RBC parameters

Ideal body weight with proper physical activity and good sleep are essential parameters for good quality of life. This study is concerned with assessing the association of general obesity, physical activity and sleeping hours with hemoglobin (Hb) concentration and red blood cell (RBC) parameters in healthy adults in Sudan. In this cross sectional study, 1086 healthy adults between 20 and 60 years were included out of which 275 were males and 811 were females. A complete blood count (CBC) was performed for Hb, RBC count, PCV, MCH and MCHC using Sysmex KX-21 automated hematology analyzer. The median and 95 percentile (2.5th to 97.5th) range values for Hb and RBC count in underweight were 13.0 (Range: 9.6-16.7) g/dl and 4.6 (Range: 3.6-5.8) ×103/µL respectively, while Hb and RBC count in obese were 13.1 (Range: 10.4-17.0) g/dl and 4.6 (Range: 3.7-5.9) ×103/µL respectively, with no significant difference. The RBC count (p=0.004) and Hb (p?0.001) were significantly high in physically active compared to physically inactive participants; whereas the hemoglobin concentration (p=0.047), red blood cells (p=0.007) and hematocrit (p?0.001) values were significantly low in long-term sleep compared to normal sleeping hours. In conclusion, there were no significant differences in hemoglobin concentration, RBC count, PCV, MCH and MCHC between unde weight, normal weight, overweight and obese persons. Increased physical activity was associated with higher Hb levels and RBC counts, while long-term sleep showed lower Hb and RBCs

Management of hepatitis C virus genotype 4: recommendations of an international expert panel.

HCV has been classified into no fewer than six major genotypes and a series of subtypes. Each HCV genotype is unique with respect to its nucleotide sequence, geographic distribution, and response to therapy. Genotypes 1, 2, and 3 are common throughout North America and Europe. HCV genotype 4 (HCV-4) is common in the Middle East and in Africa, where it is responsible for more than 80% of HCV infections. It has recently spread to several European countries. HCV-4 is considered a major cause of chronic hepatitis, cirrhosis, hepatocellular carcinoma, and liver transplantation in these regions. Although HCV-4 is the cause of approximately 20% of the 170 million cases of chronic hepatitis C in the world, it has not been the subject of widespread research. Therefore, this document, drafted by a panel of international experts, aimed to review current knowledge on the epidemiology, natural history, clinical, histological features, and treatment of HCV-4 infections

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks