The interagency relationship between the personnel department and the organization & management unit in the Arab Republic of Egypt

The development of the personal department in the Arab of Egypt is slow

Toward the Understanding of the Metabolism of Levodopa I. DFT Investigation of the Equilibrium Geometries, Acid-Base Properties and Levodopa-Water Complexes

Levodopa (LD) is used to increase dopamine level for treating Parkinson’s disease. The major metabolism of LD to produce dopamine is decarboxylation. In order to understand the metabolism of LD; the electronic structure of levodopa was investigated at the Density Functional DFT/B3LYP level of theory using the 6-311+G** basis set, in the gas phase and in solution. LD is not planar, with the amino acid side chain acting as a free rotator around several single bonds. The potential energy surface is broad and flat. Full geometry optimization enabled locating and identifying the global minimum on this Potential energy surface (PES). All possible protonation/deprotonation forms of LD were examined and analyzed. Protonation/deprotonation is local in nature, i.e., is not transmitted through the molecular framework. The isogyric protonation/deprotonation reactions seem to involve two subsequent steps: First, deprotonation, then rearrangement to form H-bonded structures, which is the origin of the extra stability of the deprotonated forms. Natural bond orbital (NBO) analysis of LD and its deprotonated forms reveals detailed information of bonding characteristics and interactions across the molecular framework. The effect of deprotonation on the donor-acceptor interaction across the molecular framework and within the two subsystems has also been examined. Attempts to mimic the complex formation of LD with water have been performed

Global prevalence and genotype distribution of hepatitis C virus infection in 2015 : A modelling study

Publisher Copyright: © 2017 Elsevier LtdBackground The 69th World Health Assembly approved the Global Health Sector Strategy to eliminate hepatitis C virus (HCV) infection by 2030, which can become a reality with the recent launch of direct acting antiviral therapies. Reliable disease burden estimates are required for national strategies. This analysis estimates the global prevalence of viraemic HCV at the end of 2015, an update of—and expansion on—the 2014 analysis, which reported 80 million (95% CI 64–103) viraemic infections in 2013. Methods We developed country-level disease burden models following a systematic review of HCV prevalence (number of studies, n=6754) and genotype (n=11 342) studies published after 2013. A Delphi process was used to gain country expert consensus and validate inputs. Published estimates alone were used for countries where expert panel meetings could not be scheduled. Global prevalence was estimated using regional averages for countries without data. Findings Models were built for 100 countries, 59 of which were approved by country experts, with the remaining 41 estimated using published data alone. The remaining countries had insufficient data to create a model. The global prevalence of viraemic HCV is estimated to be 1·0% (95% uncertainty interval 0·8–1·1) in 2015, corresponding to 71·1 million (62·5–79·4) viraemic infections. Genotypes 1 and 3 were the most common cause of infections (44% and 25%, respectively). Interpretation The global estimate of viraemic infections is lower than previous estimates, largely due to more recent (lower) prevalence estimates in Africa. Additionally, increased mortality due to liver-related causes and an ageing population may have contributed to a reduction in infections. Funding John C Martin Foundation.publishersversionPeer reviewe

Comparison between Utilization of Botox Versus Fluticasone Furoate in Patients with Intermittent Allergic Rhinitis: A Randomized, Controlled Trial

Background: Allergic rhinitis is a common disease affects about 5 to 22% from general population. Botulinum toxin is a neurotoxic protein assumed to lead to symptomatic control of intermittent allergic rhinitis. Objectives: To compare between utilization of botulinum toxin type A versus fluticasone furoate in treatment of intermittent allergic rhinitis.Patients and Methods: A randomized clinical controlled trial study created on seventy two adult patients with intermittent allergic rhinitis divided into two groups; Group B (BTX-A) and Group F (fluticasone furoate).Results: After one month the mean intensity of nasal symptoms according to VAS among the Group B (BTX-A) sneezing was 2.41 while 2.16 in Group F (fluticasone furoate). The difference is not statistically significant.Conclusions: Intranasal injection of Botulinum A(BTX-A) is a highly effective, safe, and simple procedure, with a long-lasting symptomatic relief for patients with intermittent allergic rhinitis. It as a might be used as an alternative treatment for fluticasone furoate nasal spray

Effectiveness of mometasone furoate nasal spray on tympanometric results and hearing loss in children with otitis media with effusion

Abstract Background Otitis media with effusion (OME) is one of the commonest causes of hearing loss in children. Oral and nasal topical steroids alone or combined with antibiotics lead to its quicker resolution. The aim of this study was the assessment of the efficacy of mometasone furoate nasal spray in conjunction with oral antibiotics for management of OME in children. One hundred sixty-eight children aged (4–12 years old) diagnosed with bilateral OME for at least 3 months were randomly allocated into two equal groups: the 1st group received mometasone furoate aqueous nasal spray plus oral amoxicillin–clavulanate for 4 weeks, and the 2nd group received amoxicillin–clavulanate alone for the same period. Results The tympanometric results after 1 month of medical treatment was much better in the 1st group compared to the 2nd group with 60% of patients of the 1st group having type A tympanogram versus 16% of patients of the 2nd group having this type (p = 0.0001). However, the average air-bone gap was not statistically different between the two groups. Conclusion Mometasone furoate nasal spray is effective in OME as adjunctive treatment when combined with antibiotics as it helps to normalize the Eustachian tube function and middle ear status

Technique d’implantation chirurgicale des cathéters de dialyse péritonéale. Expérience d’un centre

While performing a vascular approach is a frequent act for a surgeon working with a hemodialysis center, the implantation of a peritoneal dialysis catheter is often less frequent due to a lower number of invident patients : some centers will sometimes have less than ten new patients per year treated with PD; When a surgeon begins this activity, it is therefore important that his PD catheter implantation technique is mastered from the outset to allow the nephrologist to take care of his patient in the best conditions with a functional PD catheter regardless of the PD modality. The catheter implantation on an outpatient basis, under local or general anesthesia, makes it possible to limit the duration of hospitalization. The use of swanneck catheters with a straight extremity, a tangential pre-peritoneal path, the peroperative functional check completed by an introduction of 100 ml of dialysate, a first repair of the dressing and a first use on the tenth day allow, in our experience, to have a functional catheter in 93.5% of cases.Alors que la réalisation d'un abord vasculaire est un acte fréquent pour un chirurgien qui travaille avec un centre d'hémodialyse, l'implantation d'un cathéter de dialyse péritonéale s'avère souvent plus rare en raison d'un nombre inférieur de patients pris en charge en dialyse péritonéale (DP).  Certains centres vont parfois avoir moins de dix nouveaux patients par an traités par DP ; lorsque un chirurgien débute cette activité, il est important que sa technique d'implantation du cathéter de DP soit d'emblée maitrisée pour permette au néphrologue de prendre en charge son patient dans les meilleures conditions avec un cathéter de DP fonctionnel quelle que soit la modalité de DP.  L'implantation en ambulatoire, sous anesthésie locale ou générale, permet de limiter la durée d'hospitalisation. L'utilisation de cathéters en col de cygne à extrémité droite, un trajet pre péritonéale tangentiel, la vérification fonctionnelle per opératoire terminée par une introduction de 100 ml de dialysat, une première réfection du pansement et une première utilisation au dixième jour permettent dans notre expérience d'avoir un cathéter fonctionnel dans 93,5 % des cas

Prevalence of Obesity and Its Association With Cardiometabolic Risk Factors, Heart Failure Phenotype and Mortality Among Patients Hospitalized for Heart Failure in Egypt

BACKGROUND: Obesity is an established risk factor for cardiometabolic disease and heart failure (HF). Nevertheless, the relationship between obesity and HF mortality remains controversial. RESULTS: The goal of this study was to describe the prevalence of obesity in patients hospitalized for HF in Egypt and investigate the relationship of obesity to cardiometabolic risk factors, HF phenotype and mortality. Between 2011 and 2014, 1661 patients hospitalized for HF across Egypt were enrolled as part of the European Society of Cardiology HF Long-term Registry. Obese patients, defined by a BMI ≥ 30 kg/m, were compared to non-obese patients. Factors associated with mortality on univariate analysis were entered into a logistic regression model to identify whether obesity was an independent predictor of mortality during hospitalization and at one-year follow-up. The prevalence of obesity was 46.5% and was higher in females compared to males. Obese as compared to non-obese patients had a higher prevalence of diabetes mellitus (47.0% vs 40.2%, p = 0.031), hypertension (51.3% vs 33.0%, p \u3c 0.001) and history of myocardial infarction (69.2% vs 62.8% p = 0.005). Obese patients as compared to non-obese patient were more likely to have acute coronary syndrome on admission (24.8% vs 14.2%, p \u3c  \u3c 0.001). The dominant HF phenotype in obese and non-obese patients was HF with reduced ejection fraction (EF); however, obese patients as compared to non-obese patient had higher prevalence of HF with preserved EF (22.3% vs 12.4%, p \u3c 0.001). Multivariable analysis demonstrated that obesity was associated with an independent survival benefit during hospitalization, (OR for mortality 0.52 [95% CI 0.29-0.92]). Every point increase in BMI was associated with an OR = 0.93 [95% CI 0.89-0.98] for mortality during hospitalization. The survival benefit was not maintained at one-year follow-up. CONCLUSIONS: Obesity was highly prevalent among the study cohort and was associated with higher prevalence of cardiometabolic risk factors as compared to non-obese patients. Obesity was associated with an independent protective effect from in-hospital mortality but was not a predictor of mortality at 1-year follow-up