Concerns Regarding Organ Donation among Adult Patients with Different Health Problems in Egypt

Organ donation is the charitable act or gift of an organ to help someone who needs a transplant. Some people have religious or cultural objections to donate organs. The study aimed to describe basic knowledge and attitude (concerns) regarding organ donation among adult patients with different medical surgical health problems in Cairo-Egypt. Sample: A Convenient sample of 1000 adult patients with different health problems from different urban and rural areas was recruited for this study. Design: A descriptive comparative research design was utilized to fulfill the aim of the study and answer the stated research questions. Setting: The study was conducted at ten medical surgical wards at one educational hospital, affiliated to Cairo University. Tools: Two tools were utilized to collect data pertinent to the study which are: Personal Structured Questionnaire, and Structured Questionnaire about Basic Knowledge, and Attitudes regarding Organ Donation. Results: The study findings revealed that both urban and rural inhabitants’ patients were nearly equal regarding their knowledge and attitude toward organ donation. Current study findings showed no statistical significant difference in familiarity about the term of organ donation among study sample. Regarding attitude toward organ donation, no statistical significant differences were found among study sample in their willingness about organ donation regardless the physical condition as well as religion. Conclusion: The study concluded that being an urban or rural inhabitant didn’t affect the willingness to donate an organ but it significantly affected the level of knowledge regarding organ donation.  Recommendations: Replication of the study regarding organ donation on larger probability sample as the ensuing improved understanding of this process can be used to inform and develop clinical practice and future research in this area.  Keywords: Concerns, knowledge, attitude, organ donation, health problems

Interleukin-23p19 expression in patients with ulcerative colitis and its relation to disease severity

SummaryBackgroundThe purpose of this study was to determine whether the mucosal expression of interleukin (IL)-23p19 has a role in the pathogenesis of ulcerative colitis, and to determine its relation to disease severity.MethodsThis study was performed on 50 patients with ulcerative colitis and 10 normal individuals as the controls. They were divided into Group I (27 patients with mild to moderate disease), Group II (23 patients with severe disease), and Group III (10 normal individuals). All patients and the controls were subjected to histopathological study, IL-23p19 immunohistochemical staining, IL-23R expression by flow cytometry, and serum IL-23 by enzyme-linked immunoassay.ResultsThere was a significant increase in IL-23p19 gene expression and IL-23R level in patients with ulcerative colitis, compared to the controls. A significant positive correlation was detected between increased expression of the IL-23p19 gene, IL-23R, high serum IL-23, and the severity of the disease.ConclusionIncreased expression of the IL-23p19 gene has a role in the pathogenesis of ulcerative colitis. Targeted therapy directed against IL-23p19 may be effective in its treatment. Increased expression of the IL-23p19 gene and IL-23R with high serum IL-23 is correlated positively with disease severity

L-karnitin ublažava hepatotoksičnost bisfenola A aktiviranjem Nrf2 i inhibicijom proupalne ekspresije gena citokina u štakora

Bisphenol, used in many polycarbonate plastics and epoxy resins industries, exerts toxic effects on mammalian organs. The mechanisms underlying bisphenol toxicity are well understood, however the chemoprevention effects of L-carnitine have not yet been recorded. This study aimed to explore the protective mechanism of L-carnitine against BPA-induced hepatotoxicity. Male rats were randomly distributed into 4 groups of 10 rats each: vehicle (5 mL corn oil/kg), bisphenol (50 mg/kg b.w. orally), L-carnitine (500 mg/kg b.w. i/p), and L-carnitine bisphenol pre-treated groups. Bisphenol was dissolved in corn oil and gavaged for 70 consecutive days. Up-regulation of tumor necrosis factor (6.6-fold), and interleukin 6 (3.2-fold) mRNA transcript, along with suppression of nuclear factor erythroid 2-like 2 (0.4-fold), were recorded, following bisphenol administration. Subsequently, bisphenol provoked oxidative stress and attenuated the antioxidative molecules. Finally, hepatic dysfunction was assessed by elevated serum aminotransferases, alkaline phosphatase, lactate dehydrogenase, glutamyl transferase activities and ammonia levels, with the subsequent decline in serum albumin concentration, which confirmed the inflammatory cell infiltration and hydropic degeneration, and the impairment of lipid profile. Interestingly, co-administration of L-carnitine improved liver function and lipid profile, which was explained by the activation of nuclear factor erythroid 2-like 2 (1.5-fold) mRNA transcript, which augmented the antioxidant levels and suppressed oxidative stress, tumor necrosis factor (2.6- fold), and interleukin 6 (1.5-fold) gene expression. In conclusion, L-carnitine exerted hepatoprotective activity against bisphenol toxicity via antioxidant and anti-inflammatory effects.Bisfenol, koji se koristi u mnogim industrijama polikarbonatne plastike i epoksidnih smola, ima toksične učinke na organe sisavaca. Mehanizmi na kojima se temelji toksičnost bisfenola dobro su razumljivi, međutim učinci L-karnitina na kemoprevenciju još nisu zabilježeni. Cilj ovog ispitivanja bio je istražiti zaštitni mehanizam L-karnitina protiv hepatotoksičnosti izazvane BPA-om. Mužjaci štakora slučajnim su odabirom podijeljeni u su u 4 skupine od po 10 štakora: kontrolna skupina (5 mL kukuruznog ulja/kg tjelesne težine), duga skupina (50 mg bisfenol/kg tjelesne težine peroralno), teća skupina (500 mg L-karnitin/kg tjelesne težine i/p) i četvrta skupina (L-karnitin apliciran skupini prethodno tretiranoj bisfenolom). Bisfenol je otopljen u kukuruznom ulju kojim su štakori hranjeni 70 uzastopnih dana. Nakon primjene bisfenola zabilježeno je povećanje mRNK transkripta za stvarnje faktora tumorske nekroze i interleukina 6 uz supresiju nukleotidnog faktora sličnog eritroidu 2, povezanog s faktorom 2. Nakon toga bisfenol je izazvao oksidativni stres i oslabio antioksidativne molekule. Naposljetku, disfunkcija jetre procjenjivana je povišenim razinama aminotransferaza u serumu, alkalne fosfataze, laktat dehidrogenaze, aktivnosti glutamiltransferaze i amonijaka, uz naknadno smanjenje koncentracije serumskog albumina, što je potvrdilo infiltraciju upalnih stanica i hidropičnu degeneraciju, te narušavanje lipidnog statusa. Zanimljivo je da je istodobna primjena L-karnitina poboljšala funkciju jetre i lipidni status, što je objašnjeno aktivacijom transkripta mRNK tipa 2 povezanog s faktorom 2, koji je povećao razine antioksidansa i potisnuo oksidativni stres, te ekspresiju gena faktora tumorske nekroze i interleukina 6. Zaključno, L-karnitin je pokazao hepatozaštitnu aktivnost protiv toksičnosti bisfenola antioksidativnim i protuupalnim učincima

The Contributions of non-Muslim Scholars to The House of Wisdom

الحمد لله رب العالمين والصلاة والسلام على أشرف الخلق سيدنا محمد وعلى آل بيته الطيبين الطاهرين. إن هذا البحث الموسوم بـ(دور العلماء غير المسلمين في بيت الحكمة) يأتي ضمن الدراسات التي تسلط الضوء على دراسة الحياة العلمية في العصر العباسي الأول وأثرها، وإبراز دور هؤلاء العلماء الذين أسهموا في تطور الحياة العلمية في العصر العباسي، إذ لم يقتصر على تطور العلوم على العرب المسلمين فحسب لذا كانت مؤلفاتهم قد أخذت حيزها في مكتبة بيت الحكمة التي كانت أنموذجاً في هذا المجال. لذا بات من الضروري التعرف على أهم العلماء المشهورين منهم، فضلاً عن التعرف على نتاجاتهم العلمية التي أُعدت لخدمة العلم وأهله. وقد تضمن البحث على مقدمة ومبحثين وخاتمه ثم ثبت للمصادر والمراجع، تنأول المبحث الأول  جذور بيت الحكمة العباسي من التسمية والموقع والتأسيس بينما تضمن المبحث الثاني العلماء غير المسلمين في بيت الحكمة من نصارى ويهود وصابئة وفرس.The Abbasid period was a period of prosperity for the scientific movement, as it witnessed a great development in various sciences and fields, due to the emergence of a large number of scientists, writers and thinkers as well as the interest of the Abbasid caliphs in translation and spread widely, and the Abbasid period expanded in education in general, Establishment of several schools and institutions concerned with culture The libraries of the House of Wisdom, established by the Caliph al-Ma'mun, have become a place for scientists and learners of the Nile from the sciences that are stored in their shelves, as well as the place where the products of the nation Scientists in various sciences.            Bayt al-Hikma was not only embraced by Arab and Muslim scholars, but also by non-Muslim scholars such as Nasri, Jews, Sabians and Persians. Who have mastered various sciences and played a role in their development. It is therefore necessary to shed light on them to clarify their role as they are Muslims who participated in their civilizational development.                        The nature of the study necessitated dividing the research into an introduction, two papers, a conclusion, and a list of sources and references. The first topic dealt with the roots of the Abbasid House of Wisdom from the name, location, and establishment. The second topic included non-Muslim scholars in Beit al-Hikma from Christians, Jews, Sabians and Persians. The conclusion dealt with the main findings of the research

Exploring Media and Communication Students’ Perception of Egyptian Universities’ Use of Augmented Reality in Learning

The aim of this study was to investigate the perceptions of media students in Egypt universities about using augmented reality (AR) technology in learning. To achieve this, the study adopted Technology Acceptance Model (TAM) and utilized a survey questionnaire to collect data from students in seven universities across Egypt. The findings revealed that (i) the students had a positive perception about using AR in media and communication learning; (ii) many media students in Egypt were not fully aware of the various AR technology applications in media and communication education; (iii) the students identified several negative factors that may hinder their acceptance of AR technology as an instructional tool, such as poor connectivity, lack of free AR programs, and lack of training programs. Addressing these barriers could help promote the adoption of AR technology in media and communication learning among students in Egypt. The significance of the study lies in that it sheds light on the need for increased awareness and education of the potential benefits of using AR technology in media and communication learning

Efficacy of Mesenchymal Stem Cells in Suppression of Hepatocarcinorigenesis in Rats: Possible Role of Wnt Signaling

<p>Abstract</p> <p>Background</p> <p>The present study was conducted to evaluate the tumor suppressive effects of bone marrow derived mesenchymal stem cells (MSCs) in an experimental hepatocellular carcinoma (HCC) model in rats and to investigate the possible role of Wnt signaling in hepato-carcinogenesis.</p> <p>Methods</p> <p>Ninety rats were included in the study and were divided equally into: Control group, rats which received MSCs only, rats which received MSCs vehicle only, HCC group induced by diethylnitroseamine (DENA) and CCl_<b>4</b>, rats which received MSCs after HCC induction, rats which received MSCs before HCC induction. Histopathological examination and gene expression of Wnt signaling target genes by real time, reverse transcription-polymerase chain reaction (RT-PCR) in rat liver tissue, in addition to serum levels of ALT, AST and alpha fetoprotein were performed in all groups.</p> <p>Results</p> <p>Histopathological examination of liver tissue from animals which received DENA-CCl₄only, revealed the presence of anaplastic carcinoma cells and macro-regenerative nodules type II with foci of large and small cell dysplasia. Administration of MSCs into rats after induction of experimental HCC improved the histopathological picture which showed minimal liver cell damage, reversible changes, areas of cell drop out filled with stem cells. Gene expression in rat liver tissue demonstrated that MSCs downregulated <it>β-catenin</it>, proliferating cell nuclear antigen (<it>PCNA</it>), <it>cyclin D </it>and <it>survivin </it>genes expression in liver tissues after HCC induction. Amelioration of the liver status after administration of MSCs has been inferred by the significant decrease of ALT, AST and Alpha fetoprotein serum levels. Administration of MSCs before HCC induction did not show any tumor suppressive or protective effect.</p> <p>Conclusions</p> <p>Administration of MSCs in chemically induced HCC has tumor suppressive effects as evidenced by down regulation of Wnt signaling target genes concerned with antiapoptosis, mitogenesis, cell proliferation and cell cycle regulation, with subsequent amelioration of liver histopathological picture and liver function.</p

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

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

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