Comparative Study between Pregnant and Non-Pregnant Women Regarding Variation of Liver Function Tests: Assessment of Health Literacy

Context: Pregnancy is associated with normal physiological adaptive changes. Biochemical parameters reflect these changes and are distinct from the non-pregnant state. Low levels of health literacy have been shown to result in less healthy choices, riskier behavior, poorer health, less self-management, and more hospitalization among that category of adult patients.Aim: The study aimed to examine the effect of pregnancy on liver function tests among pregnant women during various trimesters of pregnancy and compare with non-pregnant and determine the patients' level of health literacy regarding the variation of liver function tests among those patients. Methods: A descriptive cross-sectional design was used to achieve the study aim. A random sample of 65 women was selected from an outpatient clinic in the maternity hospital; 54 out of them were pregnant women. Three tools were used to collect data, socio-demographic and clinical data assessment sheet; assessment of liver function tests by Cobas c 311; and health literacy management scale.Results: The sample's age range was between 20-40 years. This study revealed that; serum albumin levels decreased from the first trimester (3.7-4.7), and this decrease became progressively more accentuated as the pregnancy advanced (3.35-4.36 decreased significantly to 3.19-3.81). There was no significant decrease in serum AST between pregnant and non-pregnant women, but there was a significant decrease in ALT in pregnant women compared with non-pregnant women (11.90 Vs. 8.60 at p 0.017). In the current study, Serum alkaline phosphatase (ALP) was significantly higher (P˂0.0001) during the third trimester (63-171) compared with the second trimester (33-137), and the first trimester (36-129), and with the control group (48-122). Finally, it was found that a significant decrease in total serum bilirubin concentrations during the second (0.11-0.38) and third trimesters (0.12-0.42) compared to control (0.11-1.57) and the first trimester (0.12-0.85). Moreover, most of the studied sample has a low level of health literacy for all subscales and the total scores. Conclusion: During normal pregnancy, most values of liver function tests remain below the normal upper limits compared to non- pregnant women. Any increase in serum ALT and AST activity levels and serum bilirubin should be considered pathologic and prompt for further evaluation. Moreover, most of the studied sample has a low level of health literacy for all subscales and the total scores. The study recommended that the liver function tests should be routinely investigated during pregnancy to outline any pathologic changes. Focusing on the nurse's role, she should emphasize increasing the patient's level of health literacy regarding the variation of liver function tests. So, it is a must for nurses to develop many skills to enable them to function for this category of patients with low health literacy levels. Also, those patients should be equipped with information-seeking behavior, decision-making abilities, and problem-solving approaches along their health and illness continuum

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Impact of the sustainable waterfront proposed development of Bani-Suif corniche on the hydraulics of the Nile River

The main objective of this research is to study the impact of the new proposed development of Bani-Suif waterfront on Nile River hydraulics, developments include creating a walkway extended in the Nile and open theater which supported by piles inside the Nile. A mathematical simulation using Delft3D was created to represent the new development. Three interconnected grids with different grid sizes were created and then the domain decomposition technique was used to represent piles with small sizes inside the large grid. Model was calibrated using field data such as hydraulic measurements, water levels and discharges. It was concluded that there was no effect of the proposed development on water flow in the main channel of the Nile River except in the places close to the corniche on the west bank at the minimum discharge condition after the implementation of Bani-Suif corniche, which does not affect the sustainability of the project

Quality assessment of imported powder milk at Mansoura city, Egypt

Objectives: The objective of this study was to assess the keeping quality of powder milk sold at local markets in Mansoura City, Egypt, and to isolate the contaminated bacteria particularly Salmonella spp., E. coli and Staphylococcus aureus from these milk samples. Materials and methods: A total of 50 powder milk samples were collected from different sources at Mansoura, Egypt. The samples were subjected for physical examination to determine their pH and acidity. Microbiologcal assessment of the samples were done by Total Bacterial Count (TBC), Total Coliform Count (TCC), True fecal E. coli count, and Most Probable Number (MPN), and Total mold and yeast count. Results: Minimum and maximum values of TBC were 0.45 and times;102 cfu/gm and 5.11 and times;103 cfu/gm milk powder, respectively. On the other hand, minimum and maximum values of fungal count were 0.08 and times;102/gm and 2 and times;102/gm samples, respectively. No E. coli and Salmonella spp. could be isolated from the samples. However, 18% (n=9/50) samples were found to be contaminated with Staph. aureus. Conclusion: Based on the Egyptian Standards, the samples were satisfactory in terms of the association of Salmonella spp., E. coli, and fungi. Contamination with Staph. aureus warrans the public health. Thus, appropriate care and preventive measures are suggested. [J Adv Vet Anim Res 2016; 3(1.000): 75-78

Prevalence and molecular characterization of enteropathogenic Escherichia coli isolated from table eggs in Mansoura, Egypt

Objectives: This study was designed to assess the contamination of enterovirulent Escherichia coli with table eggs at Mansoura, Egypt. Materials and methods: A total of 100 commercially available table eggs were randomly collected from various groceries and supermarkets at Mansoura, Egypt. The samples were screened for the presence of E. coli through conventional bacteriological and biochemical analyses followed by confirmation by polymerase chain reaction. Results: Overall, 18% (n=18/100) samples were found to be contaminated with one or more E. coli isolates. All possible E. coli colonies (n=52) appeared on MacConkey agar plates during the screening process were picked for further analysis. Among the 52 suspected isolates, 24 were confirmed as E. coli, which were further serotyped using polyvalent E. coli antisera. In this study, 9 different E. coli serotypes namely O78, O114, O2, O44, O1, O125, O128, O124 and O26 were identified. Out of these 9 serological strains, 5 (O78, O2, O44, O125, O124 and O26) were positive for eae gene, and 3 (O44, O1 and O128) were positive for stx2 gene. Two serological strains (O44 and O1) were positive for both stx1 and eae genes, while O125 and O114 were positive for stx2 and eae genes. Two strains (O78 and O128) were found to be positive for all three genes (stx1, stx2 and eae). Conclusion: Ensuring hygienic measures can effectively reduce the microbial load from table eggs. [J Adv Vet Anim Res 2016; 3(1.000): 1-7

Prevalence, Methicillin Resistance and Inducible Clindamycin Resistance of Staphylococcus aureus Isolated from Retail Ice Cream in Mansoura, Egypt

 This work aimed at determination of the prevalence and antimicrobial resistance (AMR) of S. aureus species and investigating the presence of the enterotoxins (SEA and SEB) in the obtained isolates in consumed Egyptian ice cream. Thirty ice cream samples were obtained from many ice cream shops, dairy shops, supermarkets and local markets from different localities at Mansoura city. Samples were spread on Baird Parker selective agar media for bacterial isolation. The isolates were characterized by antibiotic susceptibility testing and resistance genes. S. aureus was detected in 60% (18 out of 30) of ice cream samples with a minimum and maximum count of 4x102 and 1.5x107 CFU/g, respectively. Furthermore, 4 isolates (22%) out of the total isolates (n=18) were positive for nuc gene. Of these positive isolates, one isolate (25%) was positive for mec A and sea genes, while seb was not detected. The AMR profile of molecularly positive nuc gene S. aureus isolates revealed that the highest resistance was against ampicillin, cefazolin, Cefoxitin, cefotaxime, cefepime, azithromycin and amoxycillin- clavulanic acid (100%) followed by gentamicin and erythromycin (75%), and imipenem, tetracycline and clindamycin (50%). No resistance was found to sulphamethazone-trimethoprim, doxycycline, ciprofloxacin, levofloxacin, vancomycin and linezolid. Our results showed that 100% of the molecularly positive nuc gene isolates was methicillin resistant staphylococcus aureus (MRSA) and 50% was inducible clindamycin resistant S. aureus (ICRSA). The MRSA and ICRSA are potential risks for health. Poor hygienic measures with ice cream manufacture may lead to contamination of ice cream with highly resistant enterotoxigenic S. aureus

Prevalence, Methicillin Resistance and Inducible Clindamycin Resistance of Staphylococcus aureus Isolated from Retail Ice Cream in Mansoura, Egypt

 This work aimed at determination of the prevalence and antimicrobial resistance (AMR) of S. aureus species and investigating the presence of the enterotoxins (SEA and SEB) in the obtained isolates in consumed Egyptian ice cream. Thirty ice cream samples were obtained from many ice cream shops, dairy shops, supermarkets and local markets from different localities at Mansoura city. Samples were spread on Baird Parker selective agar media for bacterial isolation. The isolates were characterized by antibiotic susceptibility testing and resistance genes. S. aureus was detected in 60% (18 out of 30) of ice cream samples with a minimum and maximum count of 4x102 and 1.5x107 CFU/g, respectively. Furthermore, 4 isolates (22%) out of the total isolates (n=18) were positive for nuc gene. Of these positive isolates, one isolate (25%) was positive for mec A and sea genes, while seb was not detected. The AMR profile of molecularly positive nuc gene S. aureus isolates revealed that the highest resistance was against ampicillin, cefazolin, Cefoxitin, cefotaxime, cefepime, azithromycin and amoxycillin- clavulanic acid (100%) followed by gentamicin and erythromycin (75%), and imipenem, tetracycline and clindamycin (50%). No resistance was found to sulphamethazone-trimethoprim, doxycycline, ciprofloxacin, levofloxacin, vancomycin and linezolid. Our results showed that 100% of the molecularly positive nuc gene isolates was methicillin resistant staphylococcus aureus (MRSA) and 50% was inducible clindamycin resistant S. aureus (ICRSA). The MRSA and ICRSA are potential risks for health. Poor hygienic measures with ice cream manufacture may lead to contamination of ice cream with highly resistant enterotoxigenic S. aureus

Effect of Food Safety Management Practices on Milk Quality and Subclinical Mastitis in Dairy Cow Farms

The study aimed to investigate the effect of management practices based on the principles of hazard analysis critical control points system application in dairy farms on bulk milk tank quality and the subclinical mastitis prevalence. The study was conducted on two dairy farms located in Dakahlia Governorate, Egypt using observation and questionnaire. Furthermore, cow hygiene scoring, subclinical mastitis prevalence using California Mastitis Testing, and electrical conductivity were evaluated. In addition, the organoleptic, chemical, and microbiological quality of bulk milk tanks were assessed. The results showed that farm I had better adoption of farm management practices (66.19%) than farm II (33.80%). The mean of udder and leg hygiene scores for cows showed no significant variation between both farms. The prevalence of subclinical mastitis in farm I was 0% (0/108), while it reached 6.25% (6/96) in farm II. No evidence of any abnormality during organoleptic examination on both farms. Referring to the chemical analyses, there was a higher significant difference between protein and SNF (p<0.05) in farm I than in farm II. However, this was not the case for fat, in which farm II showed a higher significance (p<0.05). Furthermore, farm I showed a significantly lower (p<0.05) somatic cell count. On the other hand, the total bacterial count (TBC), titratable acidity, and pH had no significant difference in both farms. Finally, these ensure the importance of hygiene management practices for udder health and milk quality.