Privacy of Patients’ medical Data under the Corona Pandemic: A Comparative Study

No one shall be subjected to arbitrary interference with his privacy, family, home or correspondence, nor to attacks upon his honor and reputation. Everyone has the right to the protection of the law against such interference or attacks.” International Covenant on Civil and Political Rights (ICCPR) 1966, Article 17: “1. No one shall be subjected to arbitrary or unlawful interference with his privacy, family, home, or correspondence, nor to unlawful attacks on his honor or reputation. 2. Everyone has the right to the protection of the law against such interference or attacks.” It is an unimpeachable fact that the world went through complete mayhem overnight due to the Covid-19 pandemic. The wheel of the economy was completely paralyzed in all countries of the world, global stock markets collapsed and the price of a barrel of American oil fell below zero, for the first time in history, due to the repercussions of the global closure resulting from the virus. The world started to apply restrictive measures to contain the plague, including social distancing, the matter which adversely impacted the general psychological state in the world. Amid those events, new cases of coronavirus infection increased among the world, as they exceeded twenty-seven million infections and more than nine hundred thousand death toll -which caused chaos among the global medical community due to the rapid spread of the epidemic and the lack of providing medical supplies needed to combat it. Medical teams around the world have yet to come up with a vaccine to prevent this epidemic. It is well noticed from the audiovisual media across the globe and social media that there is lack of privacy to the news regarding the infected patients and their medical data, notably, if they are confirmed to be infected. Sometimes, their identity is revealed by their names and photos. In some cases, one would ponder, if it is permissible to reveal the identity of the person who is infected with the virus, including revealing his name, photo and personal data? - The issue of the electronic medical record (EHR) has also raised many questions about the medical privacy of patients with the spread of the new corona pandemic, especially with the spread of the idea of the electronic medical record in most countries and the ability of that record and the data it contains to violate publication and circulation quickly. - The spread of the new Corona epidemic also showed the effectiveness and success of the idea of telemedicine which in turn seriously contributed to limiting the spread of the virus, but it also contributed at the same time to the possibility of violating the medical privacy of patients from Through the means of communication between the treating physician and the institution of care and between the person receiving treatment. - We will try to answer all these questions, with the help of what the comparative legislation has concluded in this regar

Privacy of Patients’ medical Data under the Corona Pandemic: A Comparative Study

United Nations Declaration of Human Rights (UDHR) 1948, Article 12: “No one shall be subjected to arbitrary interference with his privacy, family, home or correspondence, nor to attacks upon his honor and reputation. Everyone has the right to the protection of the law against such interference or attacks.” International Covenant on Civil and Political Rights (ICCPR) 1966, Article 17: “1. No one shall be subjected to arbitrary or unlawful interference with his privacy, family, home, or correspondence, nor to unlawful attacks on his honor or reputation. 2. Everyone has the right to the protection of the law against such interference or attacks.” It is an unimpeachable fact that the world went through complete mayhem overnight due to the Covid-19 pandemic. The wheel of the economy was completely paralyzed in all countries of the world, global stock markets collapsed and the price of a barrel of American oil fell below zero, for the first time in history, due to the repercussions of the global closure resulting from the virus. The world started to apply restrictive measures to contain the plague, including social distancing, the matter which adversely impacted the general psychological state in the world. Amid those events, new cases of coronavirus infection increased among the world, as they exceeded twenty-seven million infections and more than nine hundred thousand death toll -which caused chaos among the global medical community due to the rapid spread of the epidemic and the lack of providing medical supplies needed to combat it. Medical teams around the world have yet to come up with a vaccine to prevent this epidemic. It is well noticed from the audiovisual media across the globe and social media that there is lack of privacy to the news regarding the infected patients and their medical data, notably, if they are confirmed to be infected. Sometimes, their identity is revealed by their names and photos. In some cases, one would ponder, if it is permissible to reveal the identity of the person who is infected with the virus, including revealing his name, photo and personal data? - The issue of the electronic medical record (EHR) has also raised many questions about the medical privacy of patients with the spread of the new corona pandemic, especially with the spread of the idea of the electronic medical record in most countries and the ability of that record and the data it contains to violate publication and circulation quickly. - The spread of the new Corona epidemic also showed the effectiveness and success of the idea of telemedicine which in turn seriously contributed to limiting the spread of the virus, but it also contributed at the same time to the possibility of violating the medical privacy of patients from Through the means of communication between the treating physician and the institution of care and between the person receiving treatment. - We will try to answer all these questions, with the help of what the comparative legislation has concluded in this regard

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

Vitamin D receptor rs3782905 and vitamin D binding protein rs7041 polymorphisms are associated with hepatocellular carcinoma susceptibility in cirrhotic HCV patients

Abstract Background The severity of chronic hepatitis C and susceptibility to hepatocellular carcinoma (HCC) are associated with genetic variations within vitamin D receptor (VDR) in several populations. This study aims to determine the significance of the VDRs (rs2228570, rs3782905, rs11568820) and DBP (rs7041) for the susceptibility to HCC in Egyptian patients with chronic HCV infection and their effect on the progression of liver cirrhosis to carcinogenesis. Methods Single nucleotide polymorphisms (SNPs) VDR (rs2228570, rs3782905), and DBP rs7041 were genotyped using restriction fragment length-PCR (RFLP-PCR) technique and VDR rs11568820 was genotyped using single strand polymorphism PCR (SSP PCR). These SNPs genotypes, haplotypes and linkage disequilibrium analyses were examined in 299 Egyptian individuals (100 HCV-cirrhotic patients, 99 HCC- HCV patients, and 100 healthy controls). Result The VDR rs2228570 CC genotype, VDR rs3782905 GC and CC genotypes, and DBP rs7041 GG genotype are significantly higher in HCC. It is noteworthy that, VDR rs3782905 CC and DBP rs7041 TG genotypes are higher in HCV induced liver cirrhosis than with HCC progression in HCV infected patients. Furthermore, among patients, the relationship between these SNPs and smoking status, gender, and HCC susceptibility was reported. Conclusion Among the four investigated SNPs, there are associations between VDR rs3782905 and DBP rs7041 and the HCC progression in Egyptian patients chronically infected with HCV. These SNPs are considered as risk factors in HCV induced liver cirrhosis and HCC. The combinations of these SNPs with smoking status and gender are statistically linked to a high risk of HCC. Future research with a larger sample size of subjects with HCV infection is advised, because chronic liver disease induced by HCV infection is the primary cause of HCC in Egypt. We recommend screening of these SNPs for prediction of LC and HCC development in HCV infected patients, which may improve the used therapeutic protocol. These results suggest that VDR polymorphisms may be potential determinants for HCC susceptibility in Egyptian HCV patients

<i>Helicobacter pylori </i> and Hepatitis C virus coinfection in Egyptian patients

<b>Introduction:</b> Chronic hepatitis C virus (HCV) infection is a leading cause of end-stage liver disease worldwide. It has been shown that <i>Helicobacter pylori </i>(<i>H. pylori</i>) plays an important role in chronic gastritis, peptic ulcer disease and gastric malignancies, and its eradication has been advocated. The association between <i>H. pylori</i> infection and liver cirrhosis in patients with hepatitis C virus has been documented in different parts of the world; nevertheless, no conclusive data is available in Egypt. <b> Materials and Methods:</b> In the present study, the status of <i>H. pylori</i> infection was sought in 90 patients with chronic HCV infection and in 66 HCV-free healthy controls. <b> Results:</b> The study showed that the <i>H. pylori</i> positivity was increased significantly (<i>P </i>= 0.03) in the HCV-infected patients when compared to that in healthy controls, where <i>H. pylori</i> infection was found in 50 (55.6&#x0025;) out of 90 of the HCV-infected patients versus 26 (39.4&#x0025;) out of 66 of the healthy controls. In HCV-infected patients, the prevalence of <i>H. pylori</i> infection was increased significantly (<i>P </i>= 0.04) from chronic active hepatitis to cirrhosis.<i> H. pylori </i>infection was present in 6/18 (33.3&#x0025;), 10/21 (47.6&#x0025;), 16/27 (59.3&#x0025;), 18/24 (75.0&#x0025;) patients with chronic active hepatitis, Child-Pugh score A, Child-Pugh score B and Child-Pugh score C, respectively. More importantly, the prevalence of <i>H. pylori</i> infection in HCV-infected patients was increased very significantly (<i>P </i>= 0.003) with increasing Meld (model for end-stage liver disease) score. The prevalence of <i>H. pylori</i> was documented in 9/28 (32.1&#x0025;) patients with Meld score &#8804;10 and in 41/62 (66.1&#x0025;) patients with Meld score&#62; 10. <b> Conclusion:</b> It may be stated that our results collectively reflect a remarkable increase in <i>H. pylori</i> prevalence with advancing hepatic lesions, and the eradication treatment may prove beneficial in those patients with chronic hepatitis C

Helicobacter pylori and Hepatitis C Virus Coinfection in Egyptian Patients

Introduction: Chronic hepatitis C virus (HCV) infection is a leading cause of end-stage liver disease worldwide. It has been shown that Helicobacter pylori (H. pylori) plays an important role in chronic gastritis, peptic ulcer disease and gastric malignancies, and its eradication has been advocated. The association between H. pylori infection and liver cirrhosis in patients with hepatitis C virus has been documented in different parts of the world; nevertheless, no conclusive data is available in Egypt. Materials and Methods: In the present study, the status of H. pylori infection was sought in 90 patients with chronic HCV infection and in 66 HCV-free healthy controls. Results: The study showed that the H. pylori positivity was increased significantly (P = 0.03) in the HCV-infected patients when compared to that in healthy controls, where H. pylori infection was found in 50 (55.6%) out of 90 of the HCV-infected patients versus 26 (39.4%) out of 66 of the healthy controls. In HCV-infected patients, the prevalence of H. pylori infection was increased significantly (P = 0.04) from chronic active hepatitis to cirrhosis. H. pylori infection was present in 6/18 (33.3%), 10/21 (47.6%), 16/27 (59.3%), 18/24 (75.0%) patients with chronic active hepatitis, Child-Pugh score A, Child-Pugh score B and Child-Pugh score C, respectively. More importantly, the prevalence of H. pylori infection in HCV-infected patients was increased very significantly (P = 0.003) with increasing Meld (model for end-stage liver disease) score. The prevalence of H. pylori was documented in 9/28 (32.1%) patients with Meld score ≤10 and in 41/62 (66.1%) patients with Meld score> 10. Conclusion: It may be stated that our results collectively reflect a remarkable increase in H. pylori prevalence with advancing hepatic lesions, and the eradication treatment may prove beneficial in those patients with chronic hepatitis C

Association of Interleukin 27 gene polymorphism and risk of Hepatitis B viral infection in Egyptian population

Background: According to the World Health Organization, Hepatitis B virus (HBV) is considered a major global public health problem. The genetic background may be a crucial etiologic factor in HBV infection and its complications. Interleukin-27 (IL-27) is a newly discovered cytokine encoded by 2 genes (EBI3 and p28). Mutations in the IL-27 gene may lead to altered cytokine production and/or activity and thus modulate individual’s susceptibility to HVB infection. Aim of the study: This work was designed to study the association of IL-27p28 (−964A/G, 2905T/G and 4730T/C) gene promoter single nucleotide polymorphism (SNP) with the risk of Hepatitis B virus (HBV) in Egyptians. To the best of our knowledge, this study is the first one that examines IL-27p28 promoter polymorphism in Egyptian patients. Subjects and methods: One hundred and sixteen patients with HBV infection and 101 healthy controls were genotyped by using polymerase chain reaction/restriction fragment length polymorphism (PCR/RFLP) in Egyptian population. Results: There were no significant differences in the genotype and allele frequencies of IL-27p28 gene polymorphisms between patients and controls. Furthermore, no association was found between the distributions of the haplotypes and HBV risk. Conclusion: Our data suggested that polymorphisms in the IL-27 gene may not contribute to HBV susceptibility. Further studies with large sample size should be conducted to validate these results in Egyptian population

Pattern of matrix metalloproteinases-9, P53 and BCL-2 proteins in Egyptian patients with pulmonary Mycobacterium tuberculosis

Matrix metalloproteinases (MMPs) constitute a large family of enzymes that degrade extracellular matrix proteins (ECM). MMPs are implicated in different pathological conditions such as cancer. Bcl-2 and P53 are key controllers of programmed cell death (PCD) or apoptosis. The aim of the present study was to determine the MMP-9, P53 and Bcl-2 levels in Egyptian patients with Mycobacterium tuberculosis (MTB) (Group I) compared with healthy control individuals (Group II). The concentrations of serum MMP-9 were determined quantitatively using enzyme immunoassay (EIA). P53 and Bcl-2 levels were assayed by flow cytometric analysis using specific monoclones. MMP-9 level was significantly higher in MTB patients compared with healthy control. Similarly, P53 and Bcl-2 levels were increased in MTB patients compared with healthy ones. These data reflect the alteration of MMP-9 level during the course of MTB infection, accompanied with apparent dysregulation of cellular apoptosis as indicated by P53 and Bcl-2 over-expression

Naringenin suppresses NLRP3 inflammasome activation via the mRNA-208a signaling pathway in isoproterenol-induced myocardial infarction

Objective: To investigate the cardioprotective effect of naringenin against isoproterenol (ISO)-induced cardiotoxicity in rats. Methods: Rats were divided into five groups: the normal group, the ISO group (85 mg/kg b.w.); the ISO+naringenin (50 mg/kg b.w.) group, the ISO+naringenin (100 mg/kg b.w.) group and the ISO+propranolol (10 mg/kg b.w.) group. Plasma creatine kinase-MB (CK-MB), cardiac troponin T, lactate dehydrogenase, brain natriuretic peptide (BNP), and IL-10, as well as cardiac transforming growth factor-β1 (TGF-β1), vascular endothelial growth factor (VEGF) and malondialdehyde (MDA) were examined. In addition, NLRP3 and mRNA-208a expressions were evaluated by RT-PCR analysis. Histopathological examination was also performed to assess cardiac damages. Results: Naringenin treatment significantly decreased plasma lactate dehydrogenase, CK-MB, cardiac troponin T, BNP, and IL-10, as well as cardiac TGF-β1, VEGF, and MDA while increasing p-Akt and superoxide dismutase in ISO-administered rats. It also reduced NLRP3 and mRNA-208a gene expression levels. Furthermore, naringenin improved ISO-induced cardiac damage. Conclusions: Naringenin attenuates myocardial dysfunction in ISO-treated rats by decreasing oxidative stress and increasing cardiac endogenous antioxidant system, which may be modulated partly by improvement of NLRP3 and mRNA-208a gene expression

mir-146a genetic polymorphisms in systemic lupus erythematosus patients: Correlation with disease manifestations

This study aimed to investigate the genetic polymorphisms of miR-146a SNPs (rs2910164, rs57095329, and rs2431697) in systemic lupus erythematosus (SLE) patients and their association with clinical manifestations. The implication of SNPs on miR-146a expression level was also evaluated. SLE patients (113) and healthy controls (104) were registered in this study. The miR-146a SNPs were genotyped by polymerase chain reaction/restriction fragment length polymorphism (PCR-RFLP). Quantitative real-time PCR was used to measure the miR-146a expression in peripheral blood mononuclear cells (PBMCs). Our results showed that the genotype frequency of miR-146a SNPs didn't deviate significantly from the Hardy–Weinberg equilibrium (HWE). The AG genotype and G allele of miR-146a (rs57095329 A/G) might be considered a risk factor for the disease (OR = 2.27; CI: 0.78–6.57 and OR: 2.35; CI: 0.79–6.92 for AG genotype and G allele, respectively). Although, no statistical significance in the distribution of miR-146a SNPs (rs2910164, rs57095329, and rs2431697) was found, indicating the lack of association between the three SNPs and SLE susceptibility. Significantly, the higher frequency of the AA genotype of miR-146a (rs57095329) was associated with pancytopenia (P < 0.05), while the CT genotype of miR-146a (rs2431697) was associated (P < 0.05) with the antiphospholipid syndrome (APS). SLE patients had significantly higher levels of miR-146a compared to controls (P < 0.05). Elevation of miR-146a was independent of any SNP genotypes. In conclusion, this pilot study shows no association between miR-146a SNPs in our population group and susceptibility to lupus. Studies concerning other miRNAs in larger sample sizes are essential for a better understanding of their role in susceptibility to SLE disease