RESUMEN

Background Parasites are well-known immune-modulators. They inhibit some aspects of the immune system to ensure persistence inside the host for a long time; meanwhile, they stimulate other immune aspects to assure the survival of the host. Wide variations in the severity of coronavirus disease 2019 (COVID-19) among developed and developing countries were reported during the COVID-19 pandemic. Parasitic infections, including Toxoplasma gondii (T. gondii), were claimed to contribute to such variations. Methods To explore a possible relationship between latent toxoplasmosis and COVID-19 severity, our study included 44 blood samples from moderate/severe COVID-19 patients, who were admitted to Mansoura University Hospitals, Egypt, during the pandemic. Patients' sera were screened for Toxoplasma IgG antibodies using ELISA (Roche Diagnostics, Indianapolis, USA), and the gene expression of important immune markers (iNOS, arginase-1, IFN-γ, TNF-α, IL-6, IL-10, and TGF-ß) was checked using real-time quantitative PCR. Clinical and laboratory data were obtained from the patients' medical records. Results Toxoplasma IgG antibodies were detected in 33 (75%) of patients. None of the studied clinical or laboratory parameters showed any significant changes in relation to toxoplasmosis seroprevalence. Further classification of the patients according to COVID-19 severity and Toxoplasma seroprevalence did not reveal any changes related to toxoplasmosis as well. Conclusion Our study indicates that latent toxoplasmosis has no effect on the severity of COVID-19.

RESUMEN

Objectives: In this study, we aimed to assess the impact of serum vitamin D level in systemic lupus erythematosus (SLE) patients with novel coronavirus-2019 (COVID-19) disease on severity of infection, duration of COVID-19 disease course, and fatigue development as a complication of both SLE and COVID-19. Patients and methods: Between April 2020 and January 2021, a total of 38 patients (31 males, 7 females; mean age: 49.2±8.1 years; range, 38 to 65 years) who were previously diagnosed with SLE and on different lines of lupus management were included. The patients presented to chest outpatient clinic and emergency hospital with manifestations suggesting COVID-19 infection. Vitamin D levels were measured in serum by enzymelinked immunosorbent assay (ELISA). Vitamin D supplement was added to treatment protocols for COVID-19. Results: Thirteen (34.2%) patients had normal baseline serum vitamin D levels (≥30 ng/mL), nine (23.7%) patients had vitamin D insufficiency (21 to 29 ng/mL), and 16 (42.1%) patients had vitamin D deficiency (≤20 ng/mL). Low vitamin D levels (insufficiency & deficiency) patients had long SLE disease duration (p=0.06). Also, there was a significant long time spent until recovery from COVID-19 infection in low vitamin D levels (insufficiency & deficiency) patient groups versus those with normal vitamin D (p=0.019). Low baseline vitamin D level patients mainly presented with severe COVID19 symptoms (p=0.04). Patients recovered from COVID-19 had normal vitamin D levels than those who died or were lost to follow-up (p=0.07). After recovery from COVID-19, fatigue was more common in SLE patients with low baseline vitamin D level. Conclusion: Vitamin D seems to play a certain role in the management of COVID-19 infection in SLE patients. Patients with normal vitamin D levels have less severe symptoms, shorter time to recovery, improved COVID-19 outcomes, and less development of fatigue after COVID-19 infection.

RESUMEN

BACKGROUND: The Universal Health Insurance System (UHIS) has currently entered into service in July 2019 in Port-Said, a small governorate in Egypt, as a pilot to be generalized in 5 phases. OBJECTIVES: The study aimed to compare the quality of referral practice under the UHIS and the traditional system (Mansoura). METHODS: A comparative cross-sectional study that was conducted in the duration from July 2019 to June 2020, targeted all physicians and nurses working in primary health care (PHC) sites and hospitals within the UHIS (204 doctors, 396 nurses) with an equal number from PHC sites and hospitals in Mansoura (205 doctors and 395 nurses). A predesigned validated self-administered questionnaire was used to collect data. RESULTS: The study included 1200 physicians and nurses. Results showed that receiving referrals without letters and referrals not conforming with the rules were significantly lower in the UHIS (13.4% vs. 50.2%, and 39.5% vs. 60.7%, respectively). Denying a referral was significantly higher in the UHIS (38.8% vs. 21%, P ≤ 0.001). The drawbacks in the referral system were less reported in the UHIS (P ≤ 0.001 for most items). There were no significant differences regarding the presence of rules for referral or attending training courses related to the referral process (P = 0.269, P = 0.188, respectively). CONCLUSIONS: The study indicates that considerable improvements in the quality of the referral process were achieved. However, the system needs more efforts related to in-service training of the staff, feedback letter.

Asunto(s)

RESUMEN

BACKGROUND: Transducin-like enhancer of split 1 (TLE1( is a member of the TLE family of transcriptional co-repressors that control the transcription of a wide range of genes. The aim of this study was to evaluate the prognostic role of TLE1 gene expression in patients with T-cell acute lymphoblastic leukemia (T-ALL). METHOD: This study was conducted on 97 newly diagnosed T-ALL patients admitted to the Mansoura University oncology center (59 males and 38 females) with median age (33 years) in addition to 102 apparently healthy individuals served as a control group. TLE1 gene expression was measured in both patients and control groups by real time - PCR. The calculation of relative gene expression was done using the ΔΔCt method. RESULTS: TEL1 gene expression was significantly down regulated in T-ALL cases (median 2.83) as compared to controls (median 84.65) (p < 0.001). The low TEL1 gene expression was significantly associated with CNS infiltration, non-remission and higher relapse rate (p < 0.001, 0.001 and 0.023 respectively). Likewise, Low TEL1 gene expression was significantly associated with shorter OS and DFS (P= 0.012 and 0.011 respectively). Furthermore, Low TEL1 gene expression was considered as risk predictor of relapse with OR 3.636(CI.1.422-9.295) (P =0.007); and OR 0.803(CI. 0.609-0.96) (P=0.021) and independent predictor of T-ALL patient's outcome with OR 0.619 (CI. 0.44-0.872) (P=0.006). CONCLUSION: TLE1 gene expression was significantly down regulated in T-ALL cases as compared with controls. Low TLE1 expression is independent predictor of the T-ALL patient's outcome.
.

Asunto(s)

RESUMEN

The current study is a health facility-based cross-sectional study that aims to measure the prevalence of psychological distress and to determine its associated factors among primary healthcare (PHC) service users in Mansoura district, Egypt. The study included service users aged ≥18 years. A predesigned structured interviewer-administered questionnaire was used to collect data from participants during the period from January 2018 to November 2018. The questionnaire included four sections; sociodemographic characteristics, recent history of stressful life events, history of relevant health conditions and a validated Arabic version of General Health Questionnaire, that was used to screen for psychological distress. The total calculated sample size was 573. Data was analysed using SPSS V. 16. Results indicated that the prevalence of psychological distress among PHC service users was 72.2% (95% CI: 68.6%-75.9%). Being a female, non-working, or married increased the risk of high psychological distress [OR (95%CI): 1.6 (1.2-2.4), 1.8(1.2-2.8) and 1.7 (1.1-2.8) respectively], but these factors were insignificant in multiple regression. Exposure to domestic violence (DV) and being current smokers were the only independent significant predictors of psychological distress [adjusted OR (95%CI): 3.8 (1.7-8.1) and 0.7 (0.4-0.9) respectively]. Findings indicate that psychological distress is common among PHC service users. Exposure to DV significantly predicts psychological distress, while smoking is associated with lower stress. Screening of PHC service users for mental health problems should be integrated within the PHC system.

Asunto(s)

RESUMEN

OBJECTIVE: Sound breastfeeding (BF) knowledge among health professionals is vital for proper institutional support of BF mothers. This study aims to measure both BF knowledge and self-efficacy (SE) of pediatric nurses in supporting BF and to determine their associated factors. STUDY DESIGN: A cross-sectional study was conducted in Mansoura University Children's Hospital and Mansoura New General Hospital during the period from January to March 2017. A total of 186 nurses completed a predesigned self-administered questionnaire developed by the investigators to measure BF knowledge and SE in BF counseling. RESULTS: The overall total means of BF knowledge and SE scores were 26.8 (6.4) and 3.8 (0.6), respectively. Linear regression showed that having bachelor education, working in neonatal department, having a child (aged 2-5 years) were significant independent predictors of BF knowledge score (R 2 = 0.448, p ≤ 0.001), while BF knowledge score is the only significant independent predictor of SE in BF counseling (R 2= 0.36, p ≤ 0.001). CONCLUSION: Higher pregraduation education, working in neonatal department, having children aged 2 to 5 years are independent predictors of BF knowledge. Improving BF knowledge may improve nurses' SE in supporting BF.

Asunto(s)

RESUMEN

In Egypt, The prevalence of chronic heart disease (CHD) is 8.3%. It is the principal cause of death and is responsible for 22% of total mortality. The age-adjusted mortality rate is 174 per 100,000 of population. There are many studies on traditional risk factors and CHD in Egypt but the study of novel risk factors is deficient. OBJECTIVES: The aim of the present case control study was to investigate the relation between CHD susceptibility and Endothelial Nitric Oxide Synthase (eNOS) Glu 298 Asp (G894T) and Apolipoprotein E (ApoE) gene polymorphism in a cohort of Egyptian individuals. METHODS: Genotyping of eNOS (Glu298Asp) and Apo E genes polymorphisms were done using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method for 100 CHD cases and 100 age and sex matched healthy controls. RESULTS: A statistically significant association was observed between GT and TT genotypes of endothelial nitric oxide synthase gene with CHD with OR = 2.03 and 3.5; respectively. Also, carriers of E4 allele and especially E3/E4 genotype were at higher risk of CHD with OR = 3.3 for both. Significant association was also observed between the presence of combined GTE3E4 genotype and CHD with OR = 6.6. CONCLUSION: GT and TT genotypes of endothelial nitric oxide synthase gene, E3/E4 genotype of Apo E gene polymorphism and combined GTE3E4 genotype can be considered risk factors for the development of CHD among Egyptians.

RESUMEN

BACKGROUND: Eating disorders (EDs) are serious illnesses associated with medical complications and have been increased, especially among societies with an excessive concern about weight, shape, or appearance. This study aimed to investigate the prevalence of EDs among the individuals attending weight management centers and its associated factors. METHODS: A cross-sectional study was carried out among individuals attending four weight management centers in Tanta, Gharbia Governorate, Egypt during the period from July to December 2016. Precoded interview questionnaires were used to identify the following data: sociodemographic characteristics and medical history of depression or psychological disorders and the Eating Attitude Test (EAT-40) was used to assess the attitudes, behavior, and traits associated with the EDs. RESULTS: A total of 400 participants (112 males and 288 females) were included in the study. According to EAT-40 questionnaires, the prevalence of positive and negative EDs was 65.0% (n = 260) and 35.0% (n = 140), respectively. EDs were more likely reported by females, married singles, rural residents, those with higher education, and nonworking or part-time working patients, those who were overweight or obese, and who were suffering from depression or any psychological problems. Logistic regression analysis revealed that the independent predictors of EDs were age (adjusted odds ratio [OR]: 1.06), nonworking (adjusted OR: 2.32) or part-time working (adjusted OR: 2.18), increased body weight (adjusted OR: 2.66 for overweight and adjusted OR: 1.24 for obese), and having a history of depression or any psychological problem (adjusted OR: 2.76). Factor analysis of EAT-40 revealed four factors (eating behavior, diet-related lifestyle, weight concern, and food preoccupation) that were responsible for 33.2% of the total variance. CONCLUSIONS: EDs are prevalent among individuals attending the weight management centers in a northern city in Egypt. Specific management strategies are warranted to address this commonly prevalent disease.

Asunto(s)