Problems and Functional Disabilities Among Patients with Cervical Disc and Relationship with Low Back Pain

Background: cervical disc disorder is associated with many  problems and functional disabilities which affect quality of life for patients. Neck pain is as common as low back pain which are considered from associated problems with cervical disc. Aim: This study was conducted to assess problems and functional disabilities among patients with cervical disc and relationship with low back pain. Design and Setting: A descriptive exploratory correlational study design was used and data were collected from Physical Medicine and Rehabilitation Department and it's affiliated out patient clinic of Tanta Main University Hospital. Sample: Purposive sampling of (90) patients from previous mentioned setting during follow-up period. Tools: Three tools were used for data collection: Tool (I); Sociodemographic and Medical data of the patients, Tool (II); Neck Disability Index scale to examine the degree of disability resulted from cervical disc and its effect on daily activities. Tool (III); Roland-Morris Low Back Pain and Disability Questionnaire to assess pain-related disability resulting from low back pain.  Results: As a result of this study, the majority (66.7%) of the patients had complete level of neck disability and (82.2%) of them had high level of disability due to low back pain. Moreover the majority of the patients (67.6%) had high level of disability due to low back pain associated with complete neck disability due to cervical disc. Significant positive correlation was noted between total score of neck disability index and total score of roland-morrislow back pain and disability.Conclusion and Recommendation: These results indicate that majority of the patients had complete level of neck disability and high level of disability due to low back pain. Significant positive correlation was noted between total score of neck disability index and total score of roland-morrislow back pain and disability. Further research must be done in many settings to evaluate whether disability prevention or interventions can improve functional disabilities. Keywords: Cervical disc, functional disability, Low Back Pain. DOI: 10.7176/JHMN/61-05 Publication date: April 30th 201

Association of HCV with diabetes mellitus: an Egyptian case-control study

<p>Abstract</p> <p>Background</p> <p>The highest Hepatitis C Virus (HCV) prevalence in the world occurs in Egypt. Several studies from different parts of the world have found that 13% to 33% of patients with chronic HCV have associated diabetes, mostly type II Diabetes Mellitus (DM). In Egypt the prevalence of DM is 25.4% among HCV patients. Therefore, it is important to identify the magnitude of the problem of diabetes in order to optimize the treatment of chronic hepatitis C.</p> <p>Methods</p> <p>The objective of this case-control study was to evaluate the prevalence of DM and other extrahepatic (EH) manifestations among patients with different HCV morbidity stages including asymptomatic, chronic hepatic and cirrhotic patients. In this study, 289 HCV patients older than 18 were selected as cases. Also, 289 healthy controls were included. Laboratory investigations including Liver Function tests (LFT) and blood glucose level were done. Also serological assays including cryoglobulin profile, rheumatoid factor, antinuclear antibody, HCV-PCR were performed.</p> <p>Results</p> <p>Out of 289 HCV cases, 40 (13.84%) were diabetic. Out of 289 healthy controls, 12 (4.15%) were diabetic. It was found that the diabetic HCV group mean age was [48.1 (± 9.2)]. Males and urbanians represented 72.5% and 85% respectively. Lower level of education was manifested in 52.5% and 87.5% were married. In the nondiabetic HCV group mean age was [40.7 (± 10.4)]. Males and urbanians represented 71.5% and 655% respectively. secondary and higher level of education was attained in 55.4% and 76.7% were married. Comparing between the diabetic HCV group and the non diabetic HCV group, age, residence and alcohol drinking were the only significant factors affecting the incidence of diabetes between the two groups. There was no significant difference regarding sonar findings although cirrhosis was more prevalent among diabetic HCV cases and the fibrosis score was higher in diabetic HCV patients than among the non diabetic HCV cases.</p> <p>Conclusion</p> <p>The diabetic patients in the HCV group were older, more likely to have a history of alcohol drinking than the non diabetic HCV cases. Age and alcohol drinking are factors that could potentially contribute to the development of type 2 diabetes. Logistic regression analyses showed that age and residence in urban regions were the predictive variables that could be associated with the presence of diabetes. Alcohol consumption was not a significant predictive factor.</p

Management of hepatitis C virus genotype 4: recommendations of an international expert panel.

HCV has been classified into no fewer than six major genotypes and a series of subtypes. Each HCV genotype is unique with respect to its nucleotide sequence, geographic distribution, and response to therapy. Genotypes 1, 2, and 3 are common throughout North America and Europe. HCV genotype 4 (HCV-4) is common in the Middle East and in Africa, where it is responsible for more than 80% of HCV infections. It has recently spread to several European countries. HCV-4 is considered a major cause of chronic hepatitis, cirrhosis, hepatocellular carcinoma, and liver transplantation in these regions. Although HCV-4 is the cause of approximately 20% of the 170 million cases of chronic hepatitis C in the world, it has not been the subject of widespread research. Therefore, this document, drafted by a panel of international experts, aimed to review current knowledge on the epidemiology, natural history, clinical, histological features, and treatment of HCV-4 infections

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

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

Harvesting multiple optical energies using ZnPc/CdS-QDs hybrid organic/inorganic semiconductors

The substitution of inorganic-based electronics by organic semiconducting materials is a current trend in science and technology for its economic and environmental benefits, but it is hardly progressing. The reason thereof is the lack of improved efficiency, which affects the organic semiconductors performance in many devices when compared with their inorganic-based counterparts. A recent peculiar idea of using heterostructures consisting of both organic and inorganic materials has become an auspicious solution. To this end, the ability to synthesize hybrid organic/inorganic semiconductors targeting different applications is of utmost importance. We hereby present a successful simple route to synthesize a stable homogenous hybrid organic/inorganic system consisting of zinc phthalocyanine (ZnPc) oligomers as the organic base, and Cadmium sulfide quantum dots (CdS QDs) as the inorganic part. The structural and optical characterizations of the prepared samples demonstrate new optical absorption transitions for the hybrids in the red region belonging to the ZnPc molecules, besides the original blue band absorption of the CdS QDs. This is combined with a reduced radiative emission of the whole system. Thus, the hybrid materials are capable of harvesting multiple frequencies within the visible spectra more efficiently than pure QDs, while relaxing non-radiatively rather than by emitting electrons or heat. These qualities favor the use of these hybrids as solar cell or thermal-power active materials.AE and IM are acknowledging the funding provided by the joint Russian Egyptian STDF Project No. 13756. AE is also grateful for the general administration of Missions at the Ministry of High Education in Egypt for funding the mission trip to Centro de Fisica de Materiales on 2016. CR and EO are grateful for funding from the Spanish Ministry of Economy and Competitiveness (Grant MAT2016-78293-C6-5-R, including FEDER funds) and the Interreg POCTEFA V-A Spain–France–Andorra Program (EFA 194/16/TNSI) partly fnanced by ERDF funds

A novel thermostable and halophilic thioredoxin reductase from the Red Sea Atlantis II hot brine pool

© 2019 Badiea et al. The highly extreme conditions of the lower convective layer in the Atlantis II (ATII) Deep brine pool of the Red Sea make it an ideal environment for the search for novel enzymes that can function under extreme conditions. In the current study, we isolated a novel sequence of a thioredoxin reductase (TrxR) enzyme from the metagenomic dataset established from the microbial community that resides in the lower convective layer of Atlantis II. The gene was cloned, expressed and characterized for redox activity, halophilicity, and thermal stability. The isolated thioredoxin reductase (ATII-TrxR) was found to belong to the high-molecularweight class of thioredoxin reductases. A search for conserved domains revealed the presence of an extra domain (Crp) in the enzyme sequence. Characterization studies of ATIITrxR revealed that the enzyme was halophilic (maintained activity at 4 M NaCl), thermophilic (optimum temperature was 65°C) and thermostable (60% of its activity was retained at 70°C). Additionally, the enzyme utilized NADH in addition to NADPH as an electron donor. In conclusion, a novel thermostable and halophilic thioredoxin reductase has been isolated with a unique sequence that adapts to the harsh conditions of the brine pools making this protein a good candidate for biological research and industrial applications

A novel thermostable and halophilic thioredoxin reductase from the Red Sea Atlantis II hot brine pool.

The highly extreme conditions of the lower convective layer in the Atlantis II (ATII) Deep brine pool of the Red Sea make it an ideal environment for the search for novel enzymes that can function under extreme conditions. In the current study, we isolated a novel sequence of a thioredoxin reductase (TrxR) enzyme from the metagenomic dataset established from the microbial community that resides in the lower convective layer of Atlantis II. The gene was cloned, expressed and characterized for redox activity, halophilicity, and thermal stability. The isolated thioredoxin reductase (ATII-TrxR) was found to belong to the high-molecular-weight class of thioredoxin reductases. A search for conserved domains revealed the presence of an extra domain (Crp) in the enzyme sequence. Characterization studies of ATII-TrxR revealed that the enzyme was halophilic (maintained activity at 4 M NaCl), thermophilic (optimum temperature was 65°C) and thermostable (60% of its activity was retained at 70°C). Additionally, the enzyme utilized NADH in addition to NADPH as an electron donor. In conclusion, a novel thermostable and halophilic thioredoxin reductase has been isolated with a unique sequence that adapts to the harsh conditions of the brine pools making this protein a good candidate for biological research and industrial applications

Tuning Paramagnetic effect of Co-Doped CdS diluted magnetic semiconductor quantum dots

Diluted magnetic semiconductor quantum dots (DMS-QDs) are known for their outstanding optical and magnetic properties. II–VI DMS-QDs, in particular, are interesting for spintronics, nonvolatile memory, and magneto-optical devices. Therefore, studying the optical and magnetic properties of different II-VI semiconductors doped with transition metal atoms is of great importance. Tuning II-VI QDs optical properties can be mastered by changing the QDs particle size and/or structure. However tuning the magnetic properties of DMS-QDs is still within trial and error verification, although it is crucial in targeting different applications in spintronics. We hereby demonstrate, the ability to tune the paramagnetic effect of homogeneous Co-doped CdS QDs following a co-precipitation synthesis route with different Co2+ concentrations. The structural, optical and magnetic properties have been comprehensively studied. The dopant cobalt atoms concentration and chemical-configuration were precisely tracked by x-ray photoemission spectroscopy. Excitingly, the different Co-concentrations of 2, 5 and 10% significantly improve the magnetic properties of the CdS QDs, which exhibit a paramagnetic concentration-dependent effect. With 10% of Co atoms, we were able to achieve ~ 200 x 10(-6) molar susceptibility, that is, the same value to that of pure CoS. Thus we could obtain the highest possible paramagnetic effect in the CdS semiconducting matrix exhibiting 2.76 eV band gap, i.e. in the visible range. This efficacious result encourages the use of the present method in preparing DMS-QDs materials targeting various spintronics applications.AE and IM are acknowledging the funding provided by the joint Russian Egyptian STDF project no. 13756. AE is also grateful also for the general administration of Missions at the Ministry of High Education in Egypt for funding the mission trip to Centro de Fisica de Materiales on 2016. CR and EO are grateful for funding from the Spanish Ministry of Economy and Competitiveness (grant MAT2016-78293-C6-5-R, including FEDER funds), the Basque Government (grant IT-1255-19) and the Interreg POCTEFA V-A Spain–France–Andorra Program (EFA 194/16/TNSI) partly financed by ERDF funds.Peer reviewe

Prevalence of female genital cutting among Egyptian girls

OBJECTIVE: Female genital cutting (FGC) is the collective name given to traditional practices that involve partial or total cutting away of the female external genitalia whether for cultural or other non-therapeutic reasons. In Egypt, the result of the Demographic Health Survey in 2000 revealed that 97% of married women included in the survey experienced FGC. The aim of this study is to measure the prevalence of FGC among schoolgirls in Egypt. METHODS: Multistage random technique was applied for site selection. First, Egypt was divided into five geographical areas; Greater Cairo, Lower Egypt, Upper Egypt, Sinai and Suez Canal Region. Second, from each governorate, two educational districts were selected randomly (except Luxor). In each of the selected districts, the schools were divided into primary, preparatory and secondary schools. In each education stage, the schools were divided into rural, urban, government and private. The total number of females interviewed was 38 816. FINDINGS: The prevalence of FGC among schoolgirls in Egypt was 50.3%. The prevalence of FGC was 46.2% in government urban schools, 9.2% in private urban schools and 61.7% in rural schools. Educational levels of mother and father were negatively associated with FGC (P < 0.001). The mean age of the time of FGC was 10.1 ± 2.3 years. CONCLUSION: FGC prevalence is lowering, yet more active education at the grass-roots level is needed to create change