Privatization and revolution: a critical reading of the Omar Effendi case

Privatization is a program first applied in Britain to reform the public sector, mainly to decrease its burden on government spending. Although many countries have successfully followed suit, such as Brazil, such was not the case in Egypt. This failure has become even more apparent after the 25 January Revolution in 2011, in the wake of which many Egyptian citizens and workers filed cases against entities responsible for various public sector projects. One such entity was the Omar Effendi Company, which was purchased by the Saudi Anwal Company in 2008. In 2010, a case was filed against the buyer before the Administrative Court, claiming that the contract for the sale of Omar Effendi was null and void. While the Court concurred with this claim, its decision was criticized on several grounds: competence; arbitrability, specially that previous arbitral award regarding the same issue had been handed; and, that the contract imposed illegal obligations on the buyer. Through a critical reading of the Omar Effendi case materials, including party memoranda and supporting documents, this thesis argues that the Administrative Court judgment was in violation of the law

EFFECT OF SURFACE IRRIGATION METHODS AND LAND LEVELING PRACTICES ON COTTON YIELD AND IRRIGATION PERFORMANCES AT NORTH DELTA

n/

Multidimensional Inverse Boundary Value Problem for a System of Hyperbolic Equations

In the paper we investigate the solvability of the inverse multidimensional boundary value problem for the system of hyperbolic type equations. A method is proposed to reduce the considered problem to some non infinite system of differential equations. The proposed method allows one to prove the existence and uniqueness theorems for the multidimensional inverse boundary value problems in the class of the functions with bounded smoothness

Impact of Microfinance Services on Rural Egyptian Women Empowerment: An Empirical Study

This study attempts to analyze the impact of microfinance services in empowering the Egyptian rural women. The study is also meant to obtain insights regarding factors empowering rural women through microfinance services and which factors influences most and to what extent. For that, 205 respondents out of 248 questionnaires yielding a response rate of 82.66% residing in rural areas of Egypt. Rural areas were approached with structured questionnaire by following a non-probabilistic convenience sampling technique. After computing the reliability of scales, correlation and multiple regressions was used to test hypotheses through SPSS version 16.The results indicate that four of the five factors (i.e. socio-economic status up gradation, autonomy for life choices, women position in the family/society and positive approach towards child development) have significant impact on rural women empowerment. The limitations of this study is due to a sample size of 205 Egyptian Rural women, it is recommended to increase the sample size to have more statistically reliable results that can be generalized. The efficiency and the number of the questions should be increased to improve Cronbach Alpha. It is costly to randomly select a bigger population of areas to be surveyed in rural Egypt. The limitation of the study relates to the population of rural women only used for the study, which limits the generalizability of the findings. The findings of the study are likely to be important to microfinance institutions and government in designing policy to empower rural Egyptian women socially and economically.

Guideline-led prescribing to heart failure patients in Ireland and Egypt

Introduction: Guidelines strongly recommend patients with Heart Failure (HF) be treated with multiple medications proven to improve clinical outcomes, as tolerated. Guideline-led prescribing of HF evidence-based medicines is strongly associated with improved survival, prognosis, and quality of life in HF. The guidelines strongly recommend, and the optimal patient outcomes are achieved with an appropriate prescription of target doses of all HF therapies. The degree to which gaps in medication use and dosing persist in contemporary Irish or Egyptian practices is unclear. Aim: To assess guideline-led prescribing of the evidence-based HF medications in routine clinical practice in Ireland and Egypt and to assess the prevalence of HF-specific potentially inappropriate prescribing in the same Irish and Egyptian clinical settings. Method: Firstly, a narrative literature review was undertaken to determine and compare the available data and gaps in knowledge regarding HF management in Ireland as a developed European country, and Egypt as a developing Middle-Eastern country, with a particular focus on the guideline-directed medical therapies. Secondly, a systematic review was undertaken to identify the objective quantitative tools to assess the quality of HF prescribing practice. Next, a prospective cohort study was conducted on an Irish outpatient population to evaluate the extent of use and dosing of the guideline-directed medical therapies. Then, a multicentre retrospective study was carried out in 14 Long-Term Care (LTC) facilities in Cork County to assess the prevalence of appropriate and potentially inappropriate prescribing practices. In Egypt, a longitudinal observational study was conducted in order to evaluate the prescribing quality and patterns in HF patients in an Egyptian critical care setting at discharge. Finally, a descriptive survey was developed to address the barriers to guideline-led prescribing in a middle-income setting. Results: The literature review identified many gaps in knowledge in the Egyptian and Irish literature on HF. For instance, the studies included in the review did not discuss the target dose prescribing. The systematic review identified the widespread use of the Guideline Adherence Index (GAI-3) in 13 studies worldwide in the quantitative assessment of HF prescribing. The Irish HF outpatient study showed room for optimising the prescription of the guideline-directed medical therapies in 34% of ambulatory patients. No patient achieved the 100% target dose of all three evidence-based medications. The prevalence of potentially inappropriate prescribing was 20%. The Irish LTC study showed that patients with HF were older than those without HF (84.8 ± 7.4 vs 83.4 ± 7.9 years, p-value = 0.024). Loop diuretic was the most frequently prescribed HF medication up to 88% of the total population and renin-angiotensin system inhibitors to 24.2% only. The prevalence of potentially inappropriate prescribing in LTC was 24%. On the other hand, the Egyptian longitudinal study showed the moderate adherence level at discharge from the critical care unit but the potential role of clinical pharmacy service in HF drug therapy optimisation via improving beta-blocker prescription rates by from 24% to 38% and reducing digoxin rates from 34% to 23%. However, the service did not improve the overall guideline adherence levels or the prevalence of inappropriate prescribing. The survey explored some new aspects in HF practice, such as the urgent need for locally-drafted guidelines and the more significant implementation of clinical pharmacy service to optimise the implementation of guideline-led prescribing in routine clinical practice. Conclusion: This thesis has made a significant contribution to the knowledge and generated a much needed conceptual understanding of the complexity of HF guideline-led prescribing. This work reflects the moderate adherence levels to guidelines and high prevalence of potentially inappropriate prescribing in the two countries. None of the prescribers either in Ireland or Egypt prescribed at least a renin-angiotensin system inhibitor to all HF patients despite the strong, long-standing evidence

Osteoprotegerin in juvenile rheumatoid arthritis: cross talk between the immune and the skeletal systems

Background: Previous studies have linked the decreased local production of osteoprotegerin (OPG), an osteoclastogenesis blocking agent, in the inflamed joints of rheumatoid arthritis patients to the development of bone erosion. Objective: We sought to assess OPG expression in juvenile rheumatoid arthritis (JRA) and to determine its relation to clinical and laboratory markers of disease activity, and radiologic evidence of bone resorption, as well as its relation to the type of onset, duration of illness and different therapeutic modalities. Methods: The study included 40 children and adolescents with JRA, as well as, 20 clinically healthy age- and sex- matched subjects for comparison. The patients underwent clinical evaluation for disease activity by the summed joint index and investigations including assessment of ESR, CRP, antinuclear antibodies and rheumatoid factor. were Serum levels of osteoprotegerin were assayed by ELISA in the patient and control groups. Joints were evaluated radiologically using the modified Larsen index (LI). Results: The serum levels of OPG in the patients [ median (interquartile range): 0.474 (0.4) ng/ml] were comparable to those of the control group [0.495 (0.41) ng/ml] (p=0.29). However, patients with pauciarticular onset JRA had significantly lower OPG levels [0.3 (0.23) ng/ml] than the control group (p= 0.007). The OPG levels were below the 5th percentile of the control value in 60% of pauciarticular and 16.7% of polyarticular JRA cases. Patients with polyarticular JRA had significantly higher values of ESR, activity score and Larsen indices as well as serum OPG levels (p= 0.001, 0.001, 0.002 and 0.02, respectively). OPG levels did not correlate to the ESR or the activity score index values. On the other hand, the duration of illness showed a tendency to be negatively correlated to serum OPG (r= -0.309, p=0.05). LI correlated positively to the activity score index and to the ESR in the JRA patients, whether compiled in one group or classified into subgroups according to disease onset. However, OPG was not significantly correlated to the LI (r= 0.023). The different modalities of therapy did not seem to influence the serum levels of OPG (χ2 = 4.21). Conclusion: Serum OPG expression was low in JRA, especially in the pauciarticular variety. OPG levels were higher in polyarticular JRA, but this does not necessarily have a protective effect since the proinflammatory process is known to promote also the expression of RANKL, an osteoclastogenesis enhancer. While clinical and biochemical parameters of activity, and LI did not correlate to OPG, the latter seemed to be adversely affected by increased disease duration.Keywords: Osteoprotegerin, JRA, osteoclastogenesis, RANKL, bone resorptionEgypt J Pediatr Allergy Immunol 2004; 2(1): 38-4

Globalization of rheumatology: activities of ILAR. Think global - act local

In 1997 a distinguished EULAR rheumatologist involved in the development of biologics asked somewhat ironically, “What is ILAR [International League of Associations for Rheumatology] doing?” Now, 3 years later, we are in a position to review ILAR’s activities in recent years and its plans for the future. The current ILAR Executive in its global mission statement outlined 5 areas of special interest: (1) confirming the importance of rheumatology as a specialty; (2) stimulating better education; (3) initiating and updating World Wide Web information on rheumatology; (4) continuing stimulation and support of transregional projects; and (5) tightening the links with WHO and other international health organizations. We will focus on these 5 mission issues

The Effect of Fungal Decay on Ficus Sycomorus Wood

The deterioration of wood on account of microbiological agents is an acknowledged fact. Botryodiplodia theobromae - Trichoderma longibrachiatum - Aspergillus candidus - Aspergillus ustus and Aspergillus terreus were isolated from two wooden masks dating back to the Greek- Roman period in Egypt. The chemical composition of wood is easily affected after any attack and visible changes can be noticed clearly after some time, but the degree of deterioration of wood constituents cannot be estimated unless the wood is closely studied. Ficus sycomorus wood samples, which had been infected by the fungi isolated from the masks, were studied by using X Ray Diffraction (XRD) and Fourier Transform Infrared Spectroscopy with Attenuation Total Reflection (FTIR-ATR)

Plasma Adrenomedullin level in Egyptian children and Adolescents with type 1 diabetes mellitus: relationship to microvascular complications

<p>Abstract</p> <p>Background</p> <p>Adrenomedullin (AM) is known to be elevated in different clinical situations including diabetes mellitus (DM), but its potential role in the pathogenesis of vascular complications in diabetic children and adolescents is to be clarified. Hence, the study aimed at assessment of plasma adrenomedullin levels in children and adolescents with type 1 DM and correlation of these levels with metabolic control and diabetic microvascular complications (MVC).</p> <p>Methods</p> <p>The study was performed in the Diabetes Specialized Clinic, Children's Hospital of Ain Shams University in Cairo, Egypt. It included 55 diabetic children and adolescents (mean age 13.93 ± 3.15 years) who were subdivided into 40 with no MVC and 15 with MVC. Thirty healthy subjects, age-and sex- matched were included as control group (mean age 12.83 ± 2.82 years). Patients and controls were assessed for glycosylated hemoglobin (HbA1c) and plasma adrenomedullin assay using ELISA technique.</p> <p>Results</p> <p>Mean plasma AM levels were significantly increased in patients with and without MVC compared to control group, (110.6 pg/mL, 60.25 pg/mL and 39.2 pg/mL respectively) (P < 0.01) with higher levels in those with MVC (P < 0.05). Plasma AM levels were positively correlated with both duration of diabetes (ρ = 0.703, P < 0.001) and glycemic control (HbA1c) (ρ = 0.453, P < 0.001).</p> <p>Conclusion</p> <p>Higher plasma AM levels in diabetics particularly in those with MVC & its correlation with diabetes duration and metabolic control may reflect the role of AM in diabetic vasculopathy in the pediatric age group.</p