Egyptian Propolis Alleviates Gentamicin-Induced Nephrotoxicity in Rats

The objective of this study was to evaluate the effectiveness of oral administration of ethanol extract of propolis against gentamicin induced nephrotoxicity in rats. Oral administration of ethanol extract of propolis (EEP) at doses 25, 50 and 100 mg/kg.b.wt. orally/daily for 7 days) against gentamicin- (GM) at dose 100 mg/kg b.wt., i.p./daily for 7days) induced nephrotoxicity in six equal groups of adult male Sprague-Dawley rats. Blood was collected 24 h after the last injection for determination of serum creatinine, urea, and aspartate aminotransferase (AST) activity. Rats were euthanized and kidney tissue specimens were collected for determination of oxidative/antioxidative biomarkers, gene expression for antioxidative enzymes and DNA fragmentation. Significant increase in serum creatinine, urea and AST activity at the same time, and a depletion of aspartate aminotransferase activity was recorded in renal homogenate of GM only–treated rats compared to control group. Lipid peroxidation in renal tissue showed significant elevation in GM-only treated group, however, superoxide dismutase, glutathione peroxidase and catalase and its gene expression were markedly decreased. DNA fragmentation was significantly increased in renal tissue of GM- only treated rats. Oral administration of EEP exhibited curative effects by reversing GM-induced alterations in serum biochemical and renal tissue oxidative stress biomarkers. In conclusion, propolis is effective in preventing or ameliorating oxidative stress of gentamicin

Evaluation of crude larval protein and recombinant somatic protein 26/23 (rHcp26/23) immunization against Haemonchus contortus in sheep

© Kandil, et al. Aim: The aim of this study was to evaluate the potential possibility of crude larval and recombinant (rHcp26/23) antigens of Haemonchus contortus for immunization to control sheep hemonchosis. Materials and Methods: A total of 21 lambs were divided into five groups. Lambs were immunized with larval and recombinant (rHcp26/23) proteins at day 0 and day 14 and after that challenged with 5000 infective larvae of H. contortus on day 42. An unvaccinated positive control group was challenged with L3 in the meantime. An unvaccinated negative control group was not challenged. Results: Fecal egg count reduction taking after challenge for rHcp26/23 and larval antigens was 92.2% and 38.2%, respectively, compared with the positive control group. Vaccine incited protection in rHcp26/23 and larval immunization was reflected in significant (p\u3c0.05) decreases in worm burden; 59.9% and 40.1%, respectively. Conclusion: Recombinant rHcp26/23 vaccine induced a partial immune response and had immune-protective effect against sheep hemonchosis

Prevalence and risk factors of disabilities among Egyptian preschool children: a community-based population study

Abstract Background Child disability has significant implications on their well-being and healthcare systems. Aim: This survey aimed to assess the magnitude of seven types of disability among Egyptian children aged 1 < 6 years and their socio-demographic, epidemiological, and perinatal predictors. Methods A national population-based cross-sectional household survey targeting 21,316 children from eight governorates was conducted. The screening questionnaire was derived from the WHO ten-question survey tool validated for identifying seven disability categories. Results The percentage of children with at least one disability was 8.1% as follows: speech/communication (4.4%), Mobility/physical (2.5%), Seizures (2.2%), Comprehension (1.7%), Intellectual impairment (1.4%), Visual (0.3%) and Hearing (0.2%). Age was not found to affect the odds of disability except for visual disability (significantly increased with age (AOR = 1.4, 95% CI:1.1–1.7). Male sex also increased the odds of all disabilities except visual, hearing, and seizures. Convulsions after birth significantly increased the odds of disability as follows: hearing (AOR = 8.1, 95% CI: 2.2–30.5), intellectual impairment (AOR = 4.2, 95% CI: 2.5–6.9), and mobility/physical (AOR = 3.4, 95% CI: 2.3–5.0). Preterm delivery and being kept in an incubator for more than two days after birth increased the odds for visual disability (AOR = 3.7, 95% CI: 1.1–12.1 & AOR = 3.7, 95% CI: 1.7–7.9 respectively). Cyanosis increased the odds of seizures (AOR = 4.7, 95% CI: 2.2–10.3). Low birth weight also increased the odds for all disability domains except for visual and hearing. Maternal health problems during pregnancy increased the odds for all types of disability except hearing and seizures. Higher paternal education decreased the odds for all disabilities by at least 30% except for vision and hearing. Conclusion The study found a high prevalence of disability among Egyptian children aged 1–6 years. It identified a number of modifiable risk factors for disability. The practice of early screening for disability is encouraged to provide early interventions when needed

Additional file 2 of Prevalence and risk factors of disabilities among Egyptian preschool children: a community-based population study

Additional file 2: S Table 2. All data disability less than 6

Additional file 1 of Prevalence and risk factors of disabilities among Egyptian preschool children: a community-based population study

Additional file 1: S Table 1. List of the expected and targeted children according to the governorates, locality and sociodemographic status for screening of disability among children aged 1-6 years

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

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

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: 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<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<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. Funding: National Institute for Health and Care Research