The amelioration of vitamin E on histological changes of rabbit’s brain treated with zinc oxide nanoparticles

Zinc-oxide in nanoparticles is suggested to be one of the crucial nanoparticles due to its expanse implementation in many industries, like electrons, food supplements, and maquillage and makeup. This led to more individual exposure to ZnO NPs through inspiration and skin penetration. This study objected to estimating the toxic impact of ZnO NPs on the cerebral cortex, hippocampus, and cerebellum in male rabbits by studying the gross and histological changes. Twenty-four adult male rabbits were divided randomly into four groups, comprising six animals. The first group was considered as the control group left without treatment; the second group was treated with 100 mg/kg BW of vitamin e orally, the third group was treated intraperitoneally with ZnO NPs 600 mg/kg BW, and the fourth group was treated with I/P 600 mg/kg BW of ZnO NPs in addition to 100 mg/kg BW orally of vitamin e twice weekly for twenty-one days. The histological results showed degenerative, necrotic changes in neurons with a vascular and inflammatory response in the cerebral cortex, hippocampus, and cerebellum in the second group of rabbits treated with ZnO NPs. In contrast, the treated rabbits with ZnO NPs and vitamin E revealed slight improvement in the histological picture of brain sections. Also, there was an alteration in acetylcholine levels in all groups compared with the control group

The impact of nano zinc oxide particles on the histology of the male reproductive system of adult male rabbits

The goal of our research is to evaluate the histological impact of nano ZnO particles (NZnO) on the testis and epididymis of adult male rabbits treated with I.P of 600mg/kg body weight of nano ZnO particles twice a week for three weeks and to the protective effect of vitamin E versus the effect of nano zinc oxide particles. Twenty-four adult male rabbits were used in this research and divided into four groups. The first group was the control group injected with intraperitoneal distal water, and the second group was injected with 600mg/kg body weight of nano Zno particles I.P. twice a week for three weeks, the third group was injected with 600 mg/kg body weight of nano Zno particles I.P. and co-administrated with 100 mg/kg body weight of vitamin e orally, while the fourth group received 100mg/kg body weight of vitamin e orally. The histological results showed that the nano ZnO particles treatment causes noticeable changes in the testis and epididymis. These changes are characterized by thickening of tunica albuginea of testis, degenerative and necrotic changes of germ cells lining the seminiferous tubules, arrest of spermatogenesis, giant cell formation, degeneration, and necrosis of epithelial cells lining epididymis canals. The canals are free from sperms is observed. As for the group of animals treated with nano ZnO particles co-administrated with vitamin e showed improvement in the histological changes compared with the control and group treated with vitamin e only showed normal architecture of testis and epididymis. Moreover, there is a decrease in the level concentration of Testosterone of the animals treated with nano ZnO particles compared with other groups

Microbial Load of Chicken Shawerma and the Handlers’ Compliance with Food Safety Practices in Jordan

Background: Shawerma is a popular traditional food in the Eastern Mediterranean region. Aim: The aim of this study was to assess the shawerma handlers’ compliance with food safety practices and determine the microbial load and pathogenic organisms in the ready-to-eat chicken shawerma sandwiches in the restaurants of Amman, Jordan. Methods: This cross-sectional study used mixed methods including observational checklists to determine the compliance of food safety practices by 120 chicken shawerma handlers from 40 randomly selected restaurants in Amman. Additionally, pathogenic microorganisms were assessed by laboratory analysis in the ready-to-eat chicken shawerma sandwiches. Results: Only 2.5% and 10% complied, respectively, with separating knives and boards used for chicken from the ones used for vegetables. The compliance for maintaining proper temperatures for freezers and chillers were only 62% and 67%, respectively. As for hand-washing techniques and using disposable drying papers, the adherence was 5% and 7.5%, respectively. Laboratory analysis showed that 27.5% of the ready-to-eat shawerma had unacceptable levels of microorganisms. Conclusion: Our findings showed poor compliance of food safety practices in chicken shawerma restaurants of Amman. There is a need for capacity building and periodic evaluations of food handlers’ knowledge and practices within a comprehensive food safety program, carried out by qualified trainers. Keywords: chicken shawerma, food safety, Jorda

The Impact of the COVID-19 Pandemic on Female Sexual Function in Jordan: Cross-sectional Study.

BackgroundSexual function is a complex physiological process controlled by neurovascular and endocrine mechanisms that are affected by stressful events. The sexual response cycle consists of four main phases, which are sexual desire or libido, arousal or excitement, orgasm, and resolution. The COVID-19 outbreak is one of the most stressful events historically, causing several unpleasant consequences, including major physical and mental disorders, and sexual dysfunction and alteration in sexual behavior are possible anticipated consequences of the pandemic. Moreover, there are social taboos related to sexual behavior in Jordan, and the current knowledge on changes in Jordanian female sexual function during COVID-19 pandemic is limited.ObjectiveThis study aims to evaluate the impact of COVID-19 on women's sexual function during the early COVID-19 pandemic in Jordan.MethodsThis is a cross-sectional study that employed a web-based survey to follow 200 female individuals from the general population in Jordan. The survey evaluated sexual function both during COVID-19 and 6 months prior to the pandemic. The primary outcomes investigated in this study were the changes in sexual intercourse frequency and sexual function aspects, including desire, arousal, satisfaction, orgasm, lubrication, and pain during sexual activity. Data were analyzed using paired t test, McNemar test, Pearson correlations, and multiple linear regression using SPSS 25.ResultsDuring the COVID-19 pandemic, the participants' sexual intercourse frequency increased while their sexual satisfaction was significantly changed. The proportion of participants who had 0-2 times per week of sexual intercourse was decreased during the COVID-19 pandemic compared with that before the pandemic (n=90, 45% vs n=103, 51.5%; P=.02). Conversely, the number of female individuals with 3-7 times per week of sexual intercourse increased after the pandemic compared with the prepandemic state (n=103, 51.5% vs n=91, 45.5%; P=.04). Female sexual satisfaction was significantly reduced after the COVID-19 pandemic compared with that before the pandemic (3.39 vs 3.30; P=.049). The other categories of sexual function, including desire, arousal, satisfaction, orgasm, lubrication, and dyspareunia showed no significant changes during the COVID-19 pandemic compared with the previous 6 months. There were no significant differences between the total sexual function mean scores during COVID-19 (15.73) compared with the prepandemic scores (15.85; P=.41). The total score of female sexual function during the pandemic was negatively associated with the participants' age and education level. Correlations between various demographics and sexual function categories during the COVID-19 pandemic were identified.ConclusionsThis is the first study exploring female sexual function during the COVID-19 outbreak in Jordan. The results suggest that COVID-19-associated stress is influencing women's sexual function, necessitating the provision of adequate emotional and physiological well-being support for women during similar crises

Pooled Individual Data Analysis of 5 Randomized Trials of Infant Nevirapine Prophylaxis to Prevent Breast-Milk HIV-1 Transmission

Background. In resource-limited settings, mothers infected with human immunodeficiency virus type 1 (HIV-1) face a difficult choice: breastfeed their infants but risk transmitting HIV-1 or not breastfeed their infants and risk the infants dying of other infectious diseases or malnutrition. Recent results from observational studies and randomized clinical trials indicate daily administration of nevirapine to the infant can prevent breast-milk HIV-1 transmission

Perceived attitudes and barriers towards medical research: a survey of Jordanian interns, residents, and other postgraduates

Purpose We investigated research barriers among Jordanian medical postgraduates to understand the current context of the local health research landscape and improve scholarly output. Methods Using a validated questionnaire, Jordanian interns, residents, specialists, and consultants were examined for their perceived attitudes and barriers towards research. Participants were conveniently sampled from public, university, military, and private institutions. Differences in responses were examined using the Student t-test and analysis of variance. Binary logistic regression was utilized to examine predictors of being able to publish. Results A total of 1,141 Jordanian medical postgraduates were recruited, of which 61.3% were junior postgraduates (i.e., interns and residents in their first 2 years of residency) while 38.7% were senior postgraduates (i.e., senior residents, specialists, and consultants). Around 76.0% of participants had no peer-reviewed publications. Of those with least one publication (n=273), only 31.1% had first authorships. Participants portrayed dominantly positive attitudes towards the importance of research. There were no significant differences between junior and senior postgraduates for overall attitudes (p=0.486) and knowledge barriers scores (p=0.0261). Conversely, senior postgraduates demonstrated higher mean organizational barriers (p<0.001). Seniority (odds ratio [OR], 5.268; 95% confidence interval [CI], 3.341–8.307), age (OR, 1.087; 95% CI, 1.019–1.159), academic standing (OR, 1.730; 95% CI, 1.103–2.715), and confidence (OR, 1.086; 95% CI, 1.009–1.169) were positive predictors of publication in peer reviewed journals. Conclusion The Jordanian medical research landscape is riddled with all forms of different barriers. The reworking of current and integration of new research training programs are of utmost importance

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 &lt; 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

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries