Assessing the Organic and Inorganic Pollutants of Oil Field Brine Water in Marmul Area, Sultanate of Oman

Abstract: The present work aim is to quantifying and assessing the organic and inorganic pollutants in the study area. In this study, the data from 19 Monitoring Wells (MWs) and from Marmul Main Production Station (MMPS) were used to assess the Total Petroleum Hydrocarbon (TPH) concentrations ranged from 0.170ppm and 1.582ppm with average of 0.435ppm. The concentrations and distribution of total Poly Aromatic Hydrcarbons (PAHs) in the Marmul study area were measured in MWs ranged between 0ppm and 0.806ppm. There are 7 individual PAHs observed in the monitoring wells of the studying area. Naphthalene has the highest concentration among other individual PAHs with 0.616ppm and the lowest concentration is Fluorine with concentration of 0.004ppm. The distribution of TPH and PAHs in the area trend is to increase toward the area of disposal of brines in the shallow aquifer. Also, water sample collected form well no. MW-10 which is located north of the SWD has shown highly concentrations in both TPH and PAHs over the study area. The Gas Chromatography (GC) device fingerprints of the sampling indicated that the type of petroleum hydrocarbons is same and it is similar to the one from MMPS. In this case the source of organic pollution in the area is attributed to the activity of oilfield brines. All fingerprints contain around 19 of hydrocarbon compounds from C21 to C39 and did not include pristane and phytene isprenoids. The Carbon Preference Index (CPI) in samples of the study area was ranging from 0.6 to 1.7 with average 1.18, reflecting in almost similar anthropogenic sources of pollution rather than biogenic. There are 11 trace metals had results of concentration. The lowest concentration average is for Co of 0.0002ppm and it is detected in only one monitoring well. The average concentrations of the rest of 9 trace metals are range between zeros to 1.2ppm (Sr 11.56ppm, B 1.18ppm, Mn 0.08ppm, Ba 0.03ppm, Mo, Zn and P 0.02ppm, V 0.004ppm and Cr 0.002ppm). No concentration of Cd, Pb, Al, Fe, Cu, and Ni not found in the study area. In addition, trace metals results may regard to anthropogenic and/or natural sources and its level not indicated as trace metal pollution case. Patterns in groundwater pollution are consistent with produced water contamination that affirms the pollution originating is from one source (point source) of a produced water reinjection disposal wells in the study area

Study of MicroRNA192 as an Early Marker of Nephropathy in Type 2 Diabetic Patients

Background: MicroRNAs (miRNAs) are endogenous ubiquitous non-coding single-stranded (ss) RNA transcripts, frequently of 19–25 nucleotides in length. They alter the differentiation, growth, apoptosis and proliferation of cells by interfering with protein synthesis by either inducing mRNA degradation or repressing translation. miRNAs are expressed in many diseases and different cancers such as diabetes and have the potential to become new kinds of diagnostic markers. miRNA-192 is highly expressed in kidney especially in renal cortex. Many studies have confirmed that miRNA-192 played important roles in the fibrosis of kidney and liver. Objective: This study aimed to evaluate the use of microRNA-192 as early predictor in cases of diabetic nephropathy. Patients and methods: This study was conducted on volunteers from Internal Medicine Department - Suez Canal Authority Hospitals. 80 subjects were divided into: 60 patients with type 2 diabetes mellitus (T2DM) who were further subdivided into (normal albuminuria group (n= 20), microalbuminuria group (n= 20), and macroalbuminuria group (n=20)), and 20 healthy control group. MicroRNA-192 was quantified in blood using Reverse Transcription TaqMan MicroRNA Assay.Results: There was a statistical significance decrease in micro RNA-192 level in macro-albuminuria group comparedto other groups and also in microalbuminuria group compared to normal albuminuria group and healthy control group. Conclusions: We concluded that there is a possible role of miRNA-192 in the pathogenesis and progression of diabetic kidney disease in humans. Also, blood miRNA-192 may be a useful biomarker for predicting the development and the stage of diabetic kidney disease

Basin Analysis of the Late Cretaceous Sediments in United Arab Emirates

Abstract: The Late Cretaceous Simsima Formation has been proved to be one of the most prolific reservoirs in the Arabian Basin, but still needs more investigations to be ultimately exploited.This promising formation has been subjected to a comprehensive study by various geologic disciplines to build up an adequate basin model for such formation. The study revealed that the Late Cretaceous Simsima Formation could be classified into two facies. These are Planktonic Foraminiferal Biomicrite (open marine source rock facies outcropped at Jabal Qarn El-Barr); and Rudistids Algal Foraminiferal Biomicrite (shallow marine reservoir rock facies exposed at Jabal Buhays and Jabal Malaqet) facies. This facies distribution indicates that the Late Cretaceous sea deepened towards the NNW of UAE ( Jabal Qarn El-Barr section). X-Ray diffraction analysis ensured the occurrence of open marine minerals (kaolinite and montmorillonite) within the Late Cretaceous Simsima Formation that outcropped at Jabal Qarn El-Barr. So, the Late Cretaceous Simsima Formation could act as an effective source rock (newly approved) in the northern part of UAE and a prolific reservoir rock in the other parts of UAE. The geochemical analyses also supported the occurrence of source rock facies (high TOC varies from 0.4 to 1.3 wt% and low Pr/Ph ratio) within the Late Cretaceous Simsima Formation. The petrophysical and petrographical investigations proved intercrystalline, vuggy and fracture porosity (varies from 0 to 31%) and permeability ranges from 0 to 850 md for the reservoir facies of Late Cretaceous Simsima Formation. Moreover, the occurrence of anticlinal and thrusted structures (almost acting as sealing faults) within the fractured limestones of the Late Cretaceous Simsima Formation would enhance the probability for hydrocarbon entrapment within these rocks

Prevalence of acute kidney injury in cardiac patients in the Intensive Care Unit

Background Acute kidney injury (AKI) has consistently been associated with adverse clinical outcome after acute myocardial infarction (MI). In addition, AKI is well-known as a potent predictor of the clinical course in heart failure patients. The aim of this study was to assess the prevalence and risk factors of AKI in patients with acute MI and congestive heart failure (CHF) in the ICU at Zagazig University Hospitals, Egypt. Patients and methods This study included 100 patients with acute MI and 100 patients with CHF admitted to the ICU. They were subjected to careful history taking, thorough clinical examination, ECG and echocardiographic evaluation, and laboratory investigations, including cardiac enzyme evaluation, renal profile, and fasting blood glucose. Definitions of AKI depend on the measurement of serum creatinine as a surrogate marker for the glomerular filtration rate, in addition to the calculation of estimated glomerular filtration rate. Results The proportion of patients who experienced AKI was 47% in patients with CHF and 45% in patients with acute MI. They were significantly older in age (P=0.013 and 0.004, respectively). In CHF, patients with AKI had significantly higher fasting blood sugar (P=0.011), abnormal ECG changes (P=0.001), lower ejection fraction (P=0.034), and lower diastolic dysfunction (P=0.027). However, in acute MI, patients with AKI had significantly higher fasting blood sugar (P=0.013) and higher troponin I level (P=0.015). Conclusion The most important risk factors for AKI in patients with CHF are older age, higher frequency of diabetes mellitus, abnormal ECG changes, lower ejection fraction, and diastolic dysfunction. However, high troponin I and older age are the most important risk factors for AKI in patients with acute MI. Careful monitoring of susceptible patients in the ICU is recommended for early detection and management of AKI in those patients

Postrenal transplant malignancy: Incidence, risk factors, and prognosis

The newer and potent immunosuppressive agents have successfully reduced the risk of rejection after kidney transplantation, but the development of cardiovascular diseases, infections, and malignancy is major factors limiting their success. Posttransplantation malignancy is the second most common cause of death in renal transplant recipients after cardiovascular disease; it is expected that mortality due to malignancy may become the most common cause of death within the next two decades. This study is designed to evaluate the incidence, risk factors, and types of malignancies occurring after renal transplantation and their impact on patient and graft survival. A total of 2288 patients underwent living donor renal allotransplantation in the Urology and Nephrology Center, Mansoura University, during the period between 1975 and 2011. Among these patients, 100 patients developed posttransplantation malignancy. Patients were categorized into five major groups according to their type of malignancy; Kaposi’s sarcoma (KS), non-Kaposi’s skin tumors (non-KS), posttransplant lymphoproliferative disorders (PTLD), solid tumors, and genitourinary and reproductive system (GU and RS). Overall, the incidence of cancer in renal transplant recipients was 4%. There were 83 male (83%) and 17 female patients (17%). The most frequent cancer was KS seen in 33 patients (33%). The lowest median time to development of cancer was observed in KS (35 months). The highest median time to development of cancer was observed in PTLD (133 months). The best graft survival was observed in PTLD and the worst in non-KS tumors. The best patient survival was observed in KS and the worst in GU and RS tumors. Azathioprine-based regimen was associated with a higher rate of cancer. The number of patients who died was 65 (65%). Our results indicate that the occurrence of malignancy has an important impact on short- and long-term graft and patient survival

Consensus evidence-based recommendations for transition of care for adolescents with juvenile idiopathic arthritis: meeting patients’, parents’, and rheumatologists’ perspectives

Abstract Background Transition of care means the process of educating and empowering adolescents and young adults to take an active role in their own healthcare, develop decision-making skills, and eventually transition from paediatric to adult healthcare providers. Most people do not switch doctors until they are young adults, but it can be beneficial to start preparing children earlier. We aimed to develop a specific toolkit tailored to paediatric and adult rheumatologists to assist them in transitioning of care of young people with juvenile onset rheumatic musculoskeletal diseases from the paediatric to adult rheumatology care. Results The expert panel was confined to an online survey (n = 18), all the experts completed the two rounds. At the conclusion of round 2, a total of 10 points were gathered. The range of respondents (ranks 7–9) who agreed with the recommendations was 88.9 to 100%. All 10 clinical standards identified by the scientific committee were written in the same way. Based on the answers to the structured key questions and the literature review, a structured template was developed presenting transition of care integrated pathway. Conclusion The developed rheumatology-specific guideline offers adolescents and young adults a focussed, multidisciplinary transition of care approach with equity of access, quality of care and flexibility and set up standards for transitional care for young adults with juvenile rheumatological diseases

001 Egyptian consensus-based recommendations for the diagnosis and targeted management of Kawasaki disease. An initiative by the Egyptian College of Pediatric Rheumatology

Abstract Background Kawasaki disease (kDa) is a self-limiting acute vasculitis that affects small and medium-sized vessels, and is the most common cause of acquired heart disease in children. It is also an important reason for long-term cardiac disease into adulthood. Rapid diagnosis and management of kDa is challenging due to the heterogeneity of the disease, yet is vital for improving outcome. To date, there are no Egyptian nationally agreed, evidence-based guidelines concerning the diagnosis and management of kDa in children. Consequently, treatment regimens vary broadly. Objectives To develop a consensus, evidence-based recommendations for the diagnosis, evaluation and management of children living with kDa. Methods This study was carried out to achieve an Egyptian expert consensus on a management strategy for kDa using Delphi technique. A multistep process strategy was adopted, which started by developing 16 key clinical questions by scientific committee according to the Patient/Population, Intervention, Comparison, Outcomes and Time (PICOT) approach. The core leadership team identified clinicians and researchers with expertise in pediatric rheumatology all over Egypt. An evidence-based, systematic, literature review was conducted to compile evidence for the kDa management. Delphi process was implemented (3-rounds) to reach a consensus. Results Twenty-five expert panel participated in the 3 rounds with response rate 100%. A total of 21 recommendations, categorized into 9 domains (Definition, disease activity, predicting the development of coronary disease, assessment and monitoring (lab, imaging), treatment (acute and after acute attack), management of resistant cases, management of complications (cardiac complications, MAS and arthritis), vaccination and long term follow up. The Agreement with the recommendations (rank 7–9) ranged from 83.6–95.7%. The Consensus was reached (i.e. ≥75% of respondents strongly agreed or agreed) on all the clinical standards. Algorithm for management has also been developed. Conclusion This was an expert, consensus recommendations for the diagnosis and treatment of kDa, based on best available evidence and expert opinion. The recommendations provided a management approach based on easy-to-use algorithm and with the support of complementary tests. The implication to policy, practice, research and advocacy to provide updated recommendations for better management of kDa

43 Egyptian evidence-based consensus recommendations for diagnosis and targeted management of childhood-onset systemic lupus erythematosus. An initiative by the Egyptian College of Pediatric Rheumatology

Abstract Background Childhood-onset systemic lupus erythematosus (cSLE) is a rare prototype of a multi-systemic, inflammatory, heterogeneous and potentially life-threatening autoimmune condition with quite significant linked morbidity. To date, there are no Egyptian nationally agreed, evidence-based guidelines concerning the diagnosis and management of kDa in children and treatment is often based on clinical expertise. Consequently, treatment regimens vary broadly. This work was an initiative by the Egyptian College of Paediatric Rheumatology aiming at optimising the management approaches for children and young adults with cSLE. Objective To provide evidence-based consensus recommendations for diagnosis and management of cSLE Methods This study was carried out to achieve an Egyptian expert consensus on a management strategy for cSLE using Delphi technique. A multistep process strategy was adopted, which started by developing 18 key clinical questions by scientific committee according to the Patient/Population, Intervention, Comparison, Outcomes and Time (PICOT) approach. The core leadership team identified clinicians and researchers with expertise in pediatric rheumatology all over Egypt. An evidence-based, systematic, literature review was conducted to compile evidence for the cSLE management. Delphi process was implemented (3-rounds) to reach a consensus. Results Twenty-five expert panel participated in the 3 rounds with response rate 100%. A total of 24 recommendations, categorized into 14 domains (Targeted population, criteria for classification, definition of disease activity status, definition of flare up, lab tests, treatment targets, monitoring, treatment, recommendations for specific organ system, prognostic markers, refractory condition, vaccination and transition program. The Agreement with the recommendations (rank 7–9) ranged from 84.8–94.8%. The Consensus was reached (i.e. ≥75% of respondents strongly agreed or agreed) on all the clinical standards. Algorithm for management has also been developed. Conclusion This work provided an updated management approach for cSLE patients. This evidence-based informed consensus process is expected to support uniform, high quality standards of care for children with cSLE in Egypt The implication to policy, practice, research and advocacy: to provide updated recommendations for better management of cSLE

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially