Salivary PCR detection of Helicobacter pylori DNA in Egyptian patients with dyspepsia

AbstractSeveral methods are available for detecting Helicobacter pylori infection: (1) invasive methods based on gastric biopsies, (2) non invasive methods like Urea Breath Test (UBT), serology and stool antigen tests. Importance of salivary PCR in detection of H. pylori is still questionable. To evaluate the role of salivary PCR technique in detecting H. pylori gastric affection in Egyptian patients with dyspepsia and in differentiating between functional dyspepsia and acid-ulcer syndrome. This study included 60 patients with dyspepsia classified into three groups: (Group 1) patients with gastric H. pylori and ulcers or erosions (n=20), (Group 2) patients with gastric H. pylori and no ulcers or erosions and had functional dyspepsia (n=20), (Group 3) patients without H. pylori and had functional dyspepsia (n=20). All underwent upper gastrointestinal endoscopy with biopsies, rapid urease test and salivary samples for H. pylori PCR. Significant difference between the three groups regarding salivary PCR values. No significant difference between Group 1 and Group 2 but both had significant difference with Group 3, significant difference between gastric H. pylori positive patients (n=40) and negative ones (n=20). Salivary PCR test had sensitivity of 85%, specificity of 70% in diagnosing H. pylori. PCR value of 534000Iu/ml had best sensitivity (75%) and specificity (100%) for diagnosing H. pylori, highly significant positive correlation between H. pylori gastric affection and salivary PCR values. No significant difference between patients with acid ulcer syndrome (n=20) and those with functional dyspepsia (n=40) as regard salivary PCR mean values. Salivary PCR test showed sensitivity of 100%, specificity of 50% in differentiating between patients with acid ulcer syndrome and those with functional dyspepsia. PCR value of 440000 Iu/ml had best sensitivity (100%) and specificity (55%) in differentiating acid ulcer syndrome from functional dyspepsia with non significant. H. pylori salivary PCR may be of value in diagnosing H. pylori gastric affection and is strongly correlated with it but it is of limited value in differentiating between acid ulcer syndrome and functional dyspepsia

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Effect of premature loading on punching resistance of reinforced concrete flat slabs

Premature loading of reinforced concrete flat slabs in multi storey buildings during construction may occur after shuttering removal and loading slabs earlier than usual to meet project time targets. Some case studies showed failure of flat slabs, which were prematurely loaded during the construction process before it reaches its full characteristic strength (at 28 days), which was used in structural design. This research aims to address this problem through experimental testing and design application according to current building codes. Eight specimens with dimensions of 1100 * 1100 mm and a total thickness of 120 mm were experimentally tested to study the effect of concrete age and actual compressive strength at loading on the punching shear capacity of reinforced concrete slabs. All specimens were supported by a square column with dimensions of 150 × 150 mm and loaded at the four corners with a span of 1050 mm. Accelerating admixture was used in three studied specimens to achieve higher concrete compressive strength at early ages compared to their companions of normal concrete without these admixtures. It was found that increasing concrete compressive strength of slab from 25 N/mm2 to 35 Nlmm2 (40% increase) for normal concrete, without early admixture, improved punching shear capacity by 26%, while increasing it to 45 N/mm2 (80% increase) improved punching shear capacity by 49% when the specimens were loaded 7 days after casting. In addition, using an accelerating admixture increased early concrete compressive strength, which improved punching shear capacity of reinforced concrete slab over that without accelerating admixture by 31% and 29% after 7 days and 14 days, respectively. According to inclusion of reinforcement ratio, BS8110 - 97 and EC2 design codes showed the most accurate prediction of punching shear capacity at 28 days, while ACI and ECP seemed conservative as their equations do not take steel ratio into consideration. At early ages, BS8110 - 97 and EC2 design equations did not provide accurate prediction of punching shear capacity while ACI and ECP provided reliable equations. It is highly recommended to use the actual compressive strength of concrete at early age (7 days for example) for calculating punching shear resistance of flat slabs in multi storey buildings prior to shuttering removal to prevent any premature loading

In vivo diabetic wound healing effect and HPLC–DAD–ESI–MS/MS profiling of the methanol extracts of eight Aloe species

Genus Aloe, Xanthorrhoeaceae, is well distributed all over Egypt, and many species have been used as medicinal plants; mainly reported to prevent cardiovascular diseases, cancer and diabetes. This study attempts to analyze the secondary metabolites in the methanol extract of the leaves of eight Aloe species; A. vera (L.) Burm. f., A. arborescens Mill., A. eru A. Berger, A. grandidentata Salm-Dyck, A. perfoliata L., A. brevifolia Mill., A. saponaria Haw. and A. ferox Mill. growing in Egypt. For this aim HPLC–DAD–MS/MS in negative ion mode was used. Although belonging to the same genus, the composition of each species presented different particularities. Seventy one compounds were identified in the investigated Aloe species, of which cis-p-coumaric acid derivaties, 3,4-O-(E) caffeoylferuloylquinic acid and caffeoyl quinic acid hexoside were the most common phenolic acids identified. Aloeresin E and isoaloeresin D, 2′-O-feruloylaloesin were the common anthraquinones identified. Lucenin II, vicenin II, and orientin were the common identified flavonoids in the investigated Aloe species. 6′-Malonylnataloin, aloe-emodin-8-O-glucoside, flavone-6,8-di-C-glucosides could be considered as chemotaxonomic markers for the investigated Aloe species. The eight Aloe species had significant anti-inflammatory activity, in addition to the significant acceleration of diabetic wound healing in rats following topical application of the methanol extracts of their leaves. This is the first simultaneous characterization and qualitative determination of multiple phenolic compounds in Aloe species from locally grown cultivars in Egypt using HPLC–DAD–MS/MS, which can be applied to standardize the quality of different Aloe species and the future design of nutraceuticals and cosmetic preparations. Keywords: Aloe, HPLC–DAD–MS/MS, Chemotaxonomic, Anti-inflammatory, Wound healin

Risk Identification of Building Construction Projects in Egypt

Risk identification is integral to construction management. The severe consequences of identified risk factors on time and cost performance can be addressed by improved risk management. The identification and preparation of responses to risk factors affects the risk management process directly and indirectly. Recent changes in the valuation of the Egyptian currency against foreign currencies during the last year and measures to cut down on the importation of engineering materials and equipment have had significant effects on the existing and recognized regulations concerning construction in Egypt. A pilot survey with expert engineers is a crucial step in completing research. In this research study, 15 experts were asked to discuss the collected risk factors from previous studies to verify the workability of these factors in Egypt. Thirty-five risk factors were selected during the pilot survey, which was distributed to 95 participants. To facilitate the analysis process, the collection was based on a five-point Likert scale. Therefore, redefining and arranging the risks according to the current circumstances is the main objective of this study. The proposed model identified different high-risk factors that could cumulatively affect overall performance, such as funding problems from contractors, material price fluctuations, unrealistic estimates of the duration of project activities, and shortages of construction materials in the market. Thus, to help stakeholders achieve project success, these high-risk factor components should be identified and controlled duly

Biochemical and insecticidal efficacy of clove and basil essential oils and two photosensitizers and their combinations on Aphis gossypii glover (Hemiptera: Aphididae)

The present study investigates the insecticidal and biochemical effects of two essential oils (EOs) and two photosensitizers against cotton aphids in a laboratory setting. The EOs evaluated were clove (Syzygium aromaticum L.) and basil (Ocimum basilicum), while the photosensitizers were rose bengal and rhodamine B. The individual median lethal concentrations (LC50) revealed that clove was ~4.44 times more potent than basil, and rhodamine B was ~1.34 times more potent than rose bengal. The mortality rates increased using higher concentrations of the photosensitizers and prolonging exposure time to sunlight. The most effective combination against adult aphids was found to be a mixture of sub-lethal concentrations of clove and rhodamine B, resulting in a mortality rate of 92.31%. Conversely, the combination of basil and rose bengal exhibited the lowest efficacy with a mortality rate of 33.33%. Biochemical analyses indicate that Rhodamine B, basil, and the basil-rhodamine B mixture (mixture C) significantly reduced trehalase activity. However, the protease activity significantly increased in aphids treated with rose bengal, clove, and the clove-rose bengal mixtures (mixtures A and B). The lipase activity is notably decreased upon treatment with rhodamine B and clove. Glutathione S-transferase (GST) activity decreased in aphids treated with rose bengal and the basil-rhodamine B mixtures (mixtures C and D), suggesting that GST did not play a role in detoxifying these compounds, thereby explaining the susceptibility of A. gossypii. Overall, the combination of essential oils and photosensitizers has demonstrated a synergistic effect in controlling Aphis gossypii, offering great potential as an effective strategy for aphid management

Biomechanical analysis of Sit-To-Walk movement in Parkinson’s patients

Aim: The aim of this study was to evaluate the ankle-knee-hip interaction during sit-to-walk (STW) movement and clinical functional abilities of the lower limbs in Parkinson’s patients. Methods: Twenty male patients, ages ranged from 55 to 70 years, stage ΙΙ & ΙΙΙ according to modified Hoehn and Yahr (1997) classification of disabilities and ten male healthy elderly subjects, ages ranged from 55 to 70 years, participated in this study. All subjects were assessed for; clinical functional abilities of the lower limbs, ground reaction force (GRF) & spatiotemporal data and range of motion (ROM) of hip, knee and ankle joints during STW movement. Results: The results showed very significant differences in the GRF among the normal subjects and Parkinson’s patients during STW movement. There were significant differences in hip, knee and ankle joints ROM during STW. There were significant differences in spatiotemporal findings during STW movement. The Parkinson’s disease patients did not merge the two tasks of STW while the elderly subjects merged it. There was impairment in clinical functional abilities of the lower limbs in Parkinson’s patients. Conclusion: A continuum of STW performance and clinical functional abilities whereby the healthy elderly people performed the task more efficiently than PD patients