The Effect of Hydroxychloroquine Treatment on Blood Sugar Level, Serum Lipid Profile and the Retina in Systemic Lupus Erythematosus Patients

The aim of this study was to evaluate the effect of hydroxychloroquine (HCQ) on blood sugar level, lipid profile and retina in newly diagnosed systemic lupus erythromatosus (SLE) patients. Fifty newly diagnosed SLE patients were collected from Immunology and Rheumatology outpatient clinics in Beni Suef University hospital. All patient's questionnaire included name, age, sex, smoking status, the date of the diagnosis, drugs taken during the follow up period and present history of other diseases. Only HCQ was prescribed to the patients within one year follow-up. They were with a mean (SD, range) age 30 (7.07, 25, 35) years old. Their total lipid profile which included total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL) and fasting blood sugar (FBG) and postprandial blood glucose levels (PPBG) were analyzed in MASTER LAB in Beni suef before and after 6 months from the using of HCQ as well as our patients were converted to Ophthalmology Department in Beni Suef University hospital before and at the end of six months of HCQ therapy to undergo to complete eye examinations. The mean (SD) of TC, TG, LDL, FBG and PPBG were significantly decreased after HCQ than before using it while HDL was increased at p [Med-Science 2016; 5(1.000): 57-71

The Impact of Sociodemographic, Nutritional, and Health Factors on the Incidence and Complications of COVID-19 in Egypt: A Cross-Sectional Study

This study was intended to explore sociodemographic, nutritional, and health-related factors on the incidence of COVID-19 infection within the Egyptian population by assessing the frequency and determinants of post-COVID-19 symptoms and complications. A cross-sectional study using a structured survey on 15,166 participants was adopted. The results revealed common symptoms including fever (79.1%), cough (74.5%), anosmia& ageusia (68.4%), and dyspnea (66.9%). The patients were nonsmokers (83.9%), while 9.7% were mild smokers. The percentage of infected patients with comorbidities versus those without comorbidities were 29%, 71%, respectively. The highest incidence of infection was in those patients with hypertension (14.8%) and diabetes (10.9%), especially females with age >50 years and obesity (BMI; 30–39.9). The highest risks were observed for anticoagulants in the age above 50 years, morbid obesity, presence of comorbidities, and being a healthcare worker. The predictors of clot risk were in the age above 50 years, non-educated, and eating meat and eggs. Nonetheless, the highest risk of using antidepressants was in patients >50 years and those who traveled abroad. These findings and similarities within the surrounding region, the Middle East, North Africa, and South Europe, indicate the possibility of sharing the same viral strain and characteristics that may predict a similar vaccine efficacy and response

Effect of oxygen flow on aerosol delivery from a vibrating mesh nebulizer with a holding chamber

Abstract Background A holding chamber (HC) was created to work with a vibrating mesh nebulizer (VMN) to boost the total inhalable dose for patients. In addition to the optional supply of supplemental oxygen, it facilitates intermittent and continuous nebulization. Our goal was to see how well a VMN coupled to a HC with a mouthpiece or valved facemask performed at varied oxygen flows starting at 0–6 L/min. In this study, we used a breathing simulator to simulate adults' spontaneous breathing patterns with a tidal volume of 500 mL and a 1:1 inhalation–exhalation ratio. For the combination of nebulizer and HC adapter with a valved facemask or mouthpiece, five determinations were made. Salbutamol was recovered and evaluated using high-performance liquid chromatography from the inhalation filter connected to the breathing simulator, the nebulizer reservoir chamber, and the HC. Results The amount of salbutamol in the nebulizer reservoir chamber and within the HC did not differ significantly when using a mouthpiece or a valved facemask. However, the supplied dose to the inhalation filter was increased until oxygen flow reached 2 and 3 L/min using the mouthpiece and valved facemask as interfaces, respectively. The supplied salbutamol was much higher at this flow than at the other oxygen flows. This was followed by a progressive reduction in the supplied salbutamol until the lowest given dose was reached at 6 L/min oxygen flow, p < 0.005. Conclusions The supplied doses of salbutamol to the inhalation filter were variable with the VMN connected to the HC and mouthpiece or valved facemask, with significant improvements until an oxygen flow of 2 L/min with a mouthpiece and 3 L/min with a valved facemask, followed by gradual decreases to lower values at an oxygen flow of 6 L/min. An in vivo investigation is required to further validate the findings

Pentoxifylline Effects on Hospitalized COVID-19 Patients with Cytokine Storm Syndrome: A Randomized Clinical Trial

COVID-19 is a fatal, fast-spreading pandemic, and numerous attempts are being made around the world to understand and manage the disease. COVID-19 patients may develop a cytokine-release syndrome, which causes serious respiratory diseases and, in many cases, death. The study examined the feasibility of employing legally available anti-inflammatory pentoxifylline (PTX), a low toxicity and cost medication, to mitigate the hyper-inflammation caused by COVID-19. Thirty adult patients who tested positive for SARS-CoV2 were hospitalized owing to the cytokine storm syndrome. They were given 400 mg of pentoxifylline orally TID according to the standard COVID-19 protocol of the Egyptian Ministry of Health. Besides this, a group of thirty-eight hospitalized COVID-19 patients who received the standard COVID-19 protocol was included in the study as a control group. The outcomes included laboratory test parameters, clinical improvements, and number of deaths in both groups. After receiving PTX, all patients showed a significant improvement in C reactive protein (CRP), and interleukin-6 (IL-6) levels at p p = 0.004, respectively, while there was an increase in total leukocyte count (TLC) and neutrophil-to-leucocyte ratio (NLR) at p p < 0.01, while showing no statistically significant difference in the control group. The median initial ALT (42 U/L) in the treatment group showed a decrease compared to the control group (51 U/L). No statistical significance was reported regarding clinical improvement, length of stay, and death percentages between the two groups. Our results showed no significant improvement of PTX over controls in clinical outcomes of hospitalized COVID-19 patients. Nevertheless, PTX displayed a positive effect on certain inflammatory biomarkers

Effect of Pirfenidone on Risk of Pulmonary Fibrosis in COVID-19 Patients Experiencing Cytokine Storm

Objectives: Severe stages of COVID-19 infection have been associated with the excessive discharge of pro-inflammatory mediators such as cytokines, resulting in lung deterioration, which progresses rapidly to lung fibrosis leading to acute respiratory distress syndrome. In this investigation, the efficacy and safety of the novel antifibrotic and anti-inflammatory agent, Pirfenidone, were assessed in COVID-19 patients with pulmonary fibrosis secondary to cytokine storm. In this randomized controlled study, we assigned 100 adult COVID-19 patients cytokine storm and admitted to the intensive care isolation unit into either pirfenidone added to the standard therapy (n = 47), or the standard protocol only (n = 53). High-resolution computed tomography of the chest was performed in all patients to evaluate fibrotic lesions and their progression. The results showed that the percentage of patients who developed pulmonary fibrosis during cytokine storm onset in the pirfenidone group relative to the standard group was 29.8% and 35.8%, respectively, with no significant difference between the two groups; while there was a significant increase in the proportion of patients discharged from the isolation unit with pulmonary fibrosis without progression in fibrotic lesions in the pirfenidone group compared to the standard group (21.3% and 5.7%, respectively). Furthermore, there was a significant difference concerning liver enzyme elevation and GIT disturbance incidences in the studied groups (p = 0.006 and 0.01, respectively). Our findings show that Pirfenidone inhibits fibrosis advancement in COVID-19 patients with pulmonary fibrosis and is associated with hepatotoxicity and GI distress. It may be beneficial in patients with mild to moderate COVID-19-induced pulmonary fibrosis; however, additional research is necessary

Knowledge, Attitude, and Acceptance of Sinopharm and AstraZeneca&rsquo;s COVID-19 Vaccines among Egyptian Population: A Cross-Sectional Study

Background: This study aimed to evaluate the Egyptian population&rsquo;s preference and awareness related to available COVID-19 vaccines and to determine different factors that can affect beliefs concerning these vaccines. Methods: A cross-sectional web-based study was carried out among the general population in Egypt. Data collection was conducted via an online questionnaire. Results: About 426 subjects participated in the survey. Vaccine preference is nearly equally even (50%) among all respondents. There was no significant difference in vaccine preference according to age, gender, residence, educational level, or social status. About 50% of public respondents mentioned that both AstraZeneca and Sinopharm vaccines do not offer protection against new variant COVID-19 strains. Healthcare workers are the lowest respondents to agree that vaccines offer protection against new COVID-19 variants (10.9%) compared to unemployed respondents (20.3%) and other professions (68.8%) with a statistically significant difference (p &lt; 0.005). Safety of vaccine administration among children below 18 showed statistical differences for gender and educational level predictors. Conclusions: Most of the study population has satisfying knowledge about the COVID-19 vaccine. Continuous awareness campaigns must be carried out so that the people&rsquo;s background is updated with any new information that would help in raising the trust in vaccination

Emergence of High Antimicrobial Resistance among Critically Ill Patients with Hospital-Acquired Infections in a Tertiary Care Hospital

Background and Objectives: Inappropriate antibiotic usage in hospitalized patients contributes to microbial resistance. Our study aimed to examine the incidence of clinical bacterial isolates and their antibiotic resistance burden among critically ill patients in different hospital units. Materials and Methods: A single-centered cross-sectional study was conducted in a 120-bed tertiary care hospital that included 221 critically ill patients with hospital-acquired infections. Bacterial cultures and sensitivity reports were obtained and followed by a formal analysis of the antibiogram results to explore recovered isolates&rsquo; prevalence and antibiotic susceptibility patterns. Results: Gram-negative bacteria were the most predominant pathogens among recovered isolates from the various hospital units (71%). Klebsiella sp. was the most prevalent microbe, followed by Acinetobacter sp., with an incidence level of 28% and 16.2%, respectively. Among the Gram-positive organisms, the coagulase-negative Staphylococci were the most predominant organism (11.3%), while (6.3%) methicillin-resistant Staphylococcus aureus (MRSA) isolates were recovered from different hospital units. Antibiotic sensitivity testing showed that polymyxin B was the most effective antibiotic against Gram-negative bacteria, whereas vancomycin and linezolid were the most active antibiotics against Gram-positive pathogens. Moreover, 7% of the Gram-negative bacteria isolated from different units showed positive production of extended-spectrum beta-lactamase (ESBL). Conclusions: The current study describes the high antibiotic resistance patterns in various hospital units that need extra legislation to prevent healthcare providers from misprescription and overuse of antibiotics

Genetic Variability of Antigen B among Echinococcus granulosus Egyptian Isolates

Genetic polymorphisms of encoding antigen B2 gene (AgB2) in Echinococcus granulosus were studied using PCR-RFLP and DNA sequencing among 20 Egyptian isolates. Five isolates from different host origins (humans, camels, pigs, and sheep) were collected and used. All examined isolates of each host group gave very similar patterns of PCR-RFLP after restriction enzyme digestion with AluI, with the gene size of approximately 140 bp and 240 bp for sheep and human isolates, and approximately 150 bp and 250 bp for pig and camel isolates. No digestion pattern was obtained after incubation of all studied isolates with EcoRI. These results reveal high intra-group homogeneity. DNA sequence analysis highlighted that human infecting strain showed 100% identity with respect to sheep infecting isolate, 96% and 99% with pig and camel infecting isolates, respectively