Existence and uniqueness of a periodic solution to a certain third-order neutral functional differential equation

In this paper, by applying Mawhin\u27s continuation theorem of the coincidence degree theory, some sufficient conditions for the existence and uniqueness of an (omega)-periodic solution for the following third-order neutral functional differential equation are established (dfrac{d^{3}}{dt^{3}}bigg ( x(t)-d(t)xbig (t-delta(t)big ) bigg )+a(t)ddot{x}(t)+b(t)fbig (t,dot{x}(t)big )+sum_{i=1}^{n}c_{i}(t)gbig (t,x(t-tau_{i}(t))big )=e(t)). Moreover, we present an example and a graph to demonstrate the validity of analytical conclusion

COVID-19 related knowledge and practice and barriers that hinder adherence to preventive measures among the Egyptian community. An epidemiological study in Upper Egypt

Background: This study aims to assess COVID-19 related knowledge and practice among the Egyptians in Upper Egypt and to identify barriers that hinder adherence to these preventive measures.Design and methods: We conducted a cross-sectional study using a structured questionnaire. Data was collected from 21 to 30 August 2020, via both online survey and personal interviews using a non-probability self-nominated sample.Results: A total of 731 participants completed the questionnaire. The mean age was 32.1± 2.1 and 64.3% were females. The main sources of knowledge were, Internet and Social Media followed by TV then family and friends. More than 96% of the respondents knew the origin, nature, the main symptoms, and the modes of transmission of COVID-19, however, 37.6% of them thought that COVID-19 patients must develop symptoms. 75.8% and 73.6% of the participants respectively covered their nose and mouth during sneezing and washed their hands regularly, 65.4% wore masks in crowded places, while only 31.1% and 30% of them respectively avoided touching their faces or shaking hands with friends. Knowledge and practice were positively correlated and both were linked to younger age and higher education and the female gender was also a predictor of better practice. The most common perceived barriers to adherence to preventive measures were feeling uncomfortable, forgetfulness then financial causes.Conclusions: the study subjects were aware of COVID-19 and its preventive measures however adherence to some of these measures was not prevalent amongst them, indicating an urgent need of addressing and targeting barriers that hinder adherence to COVID-19 preventive measures in the future policies to prevent the spread of COVID-19 in Egypt

Consensus evidence-based clinical practice recommendations for the diagnosis and treat-to-target management of osteoporosis in chronic kidney disease stages G4-G5D and post-transplantation: An initiative of Egyptian Academy of Bone Health

The aim of this study was to reach a consensus on an updated version of the recommendations for the diagnosis and Treat-to-Target management of osteoporosis that is effective and safe for individuals with chronic kidney disease (CKD) G4-G5D/kidney transplant. Delphi process was implemented (3 rounds) to establish a consensus on 10 clinical domains: (1) study targets, (2) risk factors, (3) diagnosis, (4) case stratification, (5) treatment targets, (6) investigations, (7) medical management, (8) monitoring, (9) management of special groups, (10) fracture liaison service. After each round, statements were retired, modified, or added in view of the experts' suggestions, and the percent agreement was calculated. Statements receiving rates of 7-9 by more than 75% of experts' votes were considered as achieving consensus. The surveys were sent to an expert panel ( = 26), of whom 23 participated in the three rounds (2 were international experts and 21 were national). Most of the participants were rheumatologists (87%), followed by nephrologists (8.7%), and geriatric physicians (4.3%). Eighteen recommendations, categorized into 10 domains, were obtained. Agreement with the recommendations (rank 7-9) ranged from 80 to 100%. Consensus was reached on the wording of all 10 clinical domains identified by the scientific committee. An algorithm for the management of osteoporosis in CKD has been suggested. A panel of international and national experts established a consensus regarding the management of osteoporosis in CKD patients. The developed recommendations provide a comprehensive approach to assessing and managing osteoporosis for all healthcare professionals involved in its management. [Abstract copyright: Copyright © 2022 by The Author(s). Published by S. Karger AG, Basel.

Premature ovarian failure in systemic lupus erythematosus patients: is it related to cyclophosphamide treatment?

Introduction Systemic lupus erythematosus (SLE) is a chronic autoimmune systemic disease that mainly affects women during the childbearing period. Cyclophosphamide (CYC) is the drug of choice for severe SLE manifestations. However, many side effects had been reported. Premature ovarian failure (POF) is one of the serious complications that can occur in SLE patients. Aim The aim was to evaluate the prevalence of POF in female patients with SLE and whether it is related to CYC treatment or not. Patients and methods One hundred women with SLE satisfying the updated revised criteria for the classification of SLE were studied. The patients were allocated into two groups: CYC-treated group (n=55) and non-CYC-treated group (n=45). Patients were interviewed and demographic characteristics, clinical and serologic profiles, and menstrual histories were recorded. Disease activity was measured by the SLE disease activity index. Serum anti-Müllerian hormone was measured as a marker for ovarian reserve assessment in the two study groups. Results Ovarian failure occurred in 15 (27.3%) patients out of the 55 SLE patients treated with CYC. The cumulative CYC dose was significantly higher in patients with ovarian failure than in those without this condition (11.7 vs. 9.5 g; P=0.001). The cumulative dose of CYC and the older age at initiation were found to be associated more with POF. Conclusion In our population of female SLE patients, CYC-induced ovarian failure is a significant problem occurring in 27.3% of SLE patients receiving CYC. So, for SLE patients in whom the use of CYC is mandatory, a lower dosage and a shorter course of this agent should be considered. Co-treatment with gonadotropin-releasing hormone agonists might persevere the future fertility and ovarian function in young women. Ovarian banking before administration of CYC could be a possible solution in certain cases

Diastolic dysfunction in patients with rheumatoid arthritis

Objective The aim of this study was to evaluate left ventricular diastolic function parameters as an early predictor of cardiac involvement in patients with rheumatoid arthritis (RA) without any evidence of hypertension, diabetes mellitus, rheumatic fever or underlying cardiac disease, detected by Doppler echocardiography and to correlate diastolic function in RA patients with different RA disease characteristics. Patients and methods Seventy-five RA patients were diagnosed according to the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria for RA and another 38 age-matched and sex-matched healthy participants were included. All patients and the control groups were submitted to M-mode, two-dimensional, Doppler (continuous and pulsed wave) echocardiography. Diastolic dysfunction was defined as when transmitral flow E/A ratio is less than one. Results Left ventricular diastolic dysfunction was found in 28 (37.3%) of 75 RA patients and four (10.5%) of 38 controls with a P value of less than 0.05. In the patients’ group, a statistically significant correlation was found between diastolic dysfunction and duration of the disease (P<0.05), and disease activity was assessed by 28 Joint Disease Activity Score (P<0.05). Conclusion Among those without a history of cardiac disease, patients with RA have a higher prevalence of diastolic dysfunction than those without RA. Diastolic dysfunction in RA was associated with disease duration and disease activity. Thus, early identification of diastolic dysfunction in asymptomatic RA patients by the use of echocardiography may provide an opportunity to manage the underlying etiology to prevent progression to diastolic heart failure

The antidiabetic effect of superparamagnetic iron oxide nanoparticles highlights the role of WNT/AMPK/mTOR/FOXO1/mitochondrial DNA in muscle and kidney

[Aim]: To explore the antidiabetic effect of superparamagnetic iron oxide nanoparticles (SPIONs)-PEG-550 and its related metabolic pathways in muscles and kidney.[Materials & methods]: Diabetes was induced in 5-day neonatal rats; after confirming diabetes, treatment with SPIONs-PEG-550 started at different doses for 4 weeks. Routine analysis of glucose, insulin, adipocytokines, urea and creatinine was performed. The expression of several genes involved in metabolic pathways and the corresponding protein levels were examined.[Results & conclusion]: SPIONs-PEG-550 normalized the disturbed glucose homeostasis, reversed insulin resistance, adjusted the serum level of adipocytokines, and improved several disturbed downstream effectors of the insulin signaling and WNT pathway in both tissues. Histological examination of the muscle and pancreas has shown almost normal functional characteristics without remarkable adverse effects on the kidney.Peer reviewe

Egyptian consensus on treat-to-target approach for osteoporosis: a clinical practice guideline from the Egyptian Academy of bone health and metabolic bone diseases

Abstract Background This study was carried out to achieve an Egyptian expert consensus on a treat-to-target management strategy for osteoporosis using Delphi technique. A scientific committee identified researchers and clinicians with expertise in osteoporosis in Egypt. Delphi process was implemented (2 rounds) to establish a consensus on 15 clinical standards: (1) concept, (2) diagnosis, (3) case identification, (4) whom to treat, (5) who should treat?, (6) case stratification and intervention thresholds, (7) falls risk, (8) investigations, (9) treatment target, (10) management, (11) optimum treatment duration, (12) monitoring, (13) drug holiday, (14) osteoporosis in men, and (15) post-fracture care and fracture liaison service. Results The surveys were sent to an expert panel (n = 25), of whom 24 participated in the two rounds. Respondents were drawn from different governorates and health centres across Egypt including the Ministry of Health. Most of the participants were rheumatologists (76%), followed by internists (8%), orthopaedic doctors (4%), rehabilitation doctors (4%), primary care (4%), and ortho-geriatrics (4%) physicians. Seventy-two recommendations, categorised into 15 sections, were obtained. Agreement with the recommendations (rank 7–9) ranged from 83.4 to 100%. Consensus was reached (i.e. ≥ 75% of respondents strongly agreed or agreed) on the wording of all 15 clinical standards identified by the scientific committee. An algorithm for the management of postmenopausal osteoporosis has been suggested. Conclusion A wide and representative panel of experts established a consensus regarding the management of osteoporosis in Egypt. The developed guidelines provide a comprehensive approach to the assessment and management of osteoporosis for all Egyptian healthcare professionals who are involved in its management