Brucellosis is a zoonosis with non-specific clinical symptoms involving multiple systems and organs. Its prevalence is low in most of EU countries, which can lead to the difficulties in laboratory and clinical diagnostic. Due to its relationship to the Ochrobactrum spp., it may be misclassified in rapid identification systems. We present a case of a 13-year-old immunocompetent girl who was examined several times for fever, fatigue, night sweats and weight loss; laboratory results showed mildly elevated C-reactive protein, anaemia and leukopenia. Four weeks before the onset of symptoms, she had been on a family holiday in Egypt. Given her symptoms, a haemato-oncological or autoimmune disease was considered more likely. The diagnosis of Brucella spondylitis was made after 4 months. The main reasons for this delay were as follows: low specificity of clinical symptoms, delay in completing the travel history, inconclusive initial serological results and misidentification of the blood culture isolate as Ochrobactrum sp. Even in countries with a low incidence of brucellosis, it is essential to educate healthcare professionals about the disease. Low specificity of symptoms and limited experience of laboratory staff may lead to late diagnosis with risk of complications and poor outcome. If Ochrobactrum spp. is detected in clinical specimens by rapid identification, careful re-evaluation must follow and all measures to prevent laboratory-acquired infections must be taken until Brucella spp. is unequivocally excluded.

• MeSH
• Bacteremia * diagnosis   microbiology   MeSH
• Brucella isolation & purification   classification   MeSH
• Brucellosis * diagnosis   microbiology   MeSH
• Diagnostic Errors * MeSH
• Gram-Negative Bacterial Infections diagnosis   microbiology   MeSH
• Fever * microbiology   etiology   MeSH
• Humans MeSH
• Adolescent MeSH
• Ochrobactrum * genetics   isolation & purification   MeSH
• Spondylitis microbiology   diagnosis   MeSH
• Check Tag
• Humans MeSH
• Adolescent MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Case Reports MeSH
• Geographicals
• Egypt MeSH

An increasing number of software tools can be used in forensic anthropology to estimate a biological profile, but further studies in other populations are required for more robust validation. The present study aimed to evaluate the validity of MorphoPASSE software for sex estimation from sexually dimorphic cranial traits recorded on 3D CT models (n = 180) from three populations samples (Czech, French, and Egyptian). Two independent observers performed scoring of 4 cranial traits (2 of them bilateral) in each population sample of 30 males and 30 females. The accuracy of sex estimation using traditional posterior probability threshold (pp = 0.5) ranged from 85.6% to 88.3% and overall classification error from 14.4% to 11.7% for both observers, and corresponds to the previously published values of the method. The MorphoPASSE method is also affected by the subjectivity of the observers, as both observers show agreement in sex assignment in 83.9% of cases, regardless of the accuracy of the estimates. Applying a higher posterior probability threshold (pp 0.95) provided classification accuracy of 97.9% and 93.3% of individuals (for observer A and B respectively), minimizing the risk of error to 2.1% and 6.7%, respectively. However, sex estimation can only be applied to 54% and 66% of individuals, respectively. Our results demonstrate the validity of the MorphoPASSE software for cranial sex estimation outside the reference population. However, the achieved classification success is accompanied by a high risk of errors, the reduction of which is only possible by increasing the posterior probability threshold.

• MeSH
• Adult MeSH
• Skull * anatomy & histology   diagnostic imaging   MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Tomography, X-Ray Computed MeSH
• Probability MeSH
• Reproducibility of Results MeSH
• Software * MeSH
• Forensic Anthropology * methods   MeSH
• Sex Determination by Skeleton * methods   MeSH
• Imaging, Three-Dimensional MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Validation Study MeSH
• Geographicals
• Egypt MeSH
• France MeSH

The rate of stroke-related death and disability is four times higher in low- and middle-income countries (LMICs) than in high-income countries (HICs), yet stroke units exist in only 18% of LMICs, compared with 91% of HICs. In order to ensure universal and equitable access to timely, guideline-recommended stroke care, multidisciplinary stroke-ready hospitals with coordinated teams of healthcare professionals and appropriate facilities are essential.Established in 2016, the Angels Initiative is an international, not-for-profit, public-private partnership. It is run in collaboration with the World Stroke Organization, European Stroke Organisation, and regional and national stroke societies in over 50 countries. The Angels Initiative aims to increase the global number of stroke-ready hospitals and to optimize the quality of existing stroke units. It does this through the work of dedicated consultants, who help to standardize care procedures and build coordinated, informed communities of stroke professionals. Angels consultants also establish quality monitoring frameworks using online audit platforms such as the Registry of Stroke Care Quality (RES-Q), which forms the basis of the Angels award system (gold/platinum/diamond) for all stroke-ready hospitals across the world.The Angels Initiative has supported over 1700 hospitals (>1000 in LMICs) that did not previously treat stroke patients to become "stroke ready." Since its inception in 2016, the Angels Initiative has impacted the health outcomes of an estimated 7.46 million stroke patients globally (including an estimated 4.68 million patients in LMICs). The Angels Initiative has increased the number of stroke-ready hospitals in many countries (e.g. in South Africa: 5 stroke-ready hospitals in 2015 vs 185 in 2021), reduced "door to treatment time" (e.g. in Egypt: 50% reduction vs baseline), and increased quality monitoring substantially.The focus of the work of the Angels Initiative has now expanded from the hyperacute phase of stroke treatment to the pre-hospital setting, as well as to the early post-acute setting. A continued and coordinated global effort is needed to achieve the target of the Angels Initiative of >10,000 stroke-ready hospitals by 2030, and >7500 of these in LMICs.

• MeSH
• Stroke * therapy   MeSH
• Quality of Health Care MeSH
• Humans MeSH
• Hospitals MeSH
• Health Personnel MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH
• Geographicals
• Egypt MeSH

Kontext: Infekční onemocnění covid-19 bylo spojeno s významnou morbiditou a mortalitou. Nepostihuje přitom pouze dýchací systém, ale byly pozorovány i četné systémové účinky jako myokarditida, arytmie a žilní tromboembolická nemoc. Cíl studie: Naším cílem bylo zjistit frekvenci výskytu rizikových faktorů kardiovaskulárních onemocnění u pacientů s onemocněním covid-19 a dopady uvedených rizikových faktorů na krátkodobý výsledek nemocniční léčby pacientů s nově diagnostikovaným onemocněním covid-19. Materiály a metody: Byla provedena průřezová analytická studie s 200 pacienty (průměrný věk 44,2 ± 12,7 roku) s onemocněním covid-19, prokázaným PCR testem, přijatými na izolační oddělení různých nemocnic v Egyptě. Pacientům byla odebrána anamnéza a byla provedena fyzikální vyšetření a vyšetření srdce. U zařazených pacientů se hodnotil profil kardiovaskulárního rizika. U všech pacientů byl natočen 12svodový elektrokardiogram, byly provedeny běžné laboratorní testy a vyšetření hrudníku výpočetní tomografií. Následně byli účastníci studie rozděleni do dvou skupin (A přeživší a B zemřelí). Údaje byly analyzovány statistickým softwarem pro sociální vědy verze 20.0 (SPSS Inc., Chicago, Illinois, USA). Výsledky: Do studie bylo řazeno 200 pacientů ve věku 20 až 79 let, většinou mužů. Ve studii přežilo 181 účastníků (90,5 %; skupina A), 19 pacientů (9,5 %; skupina B) zemřelo. Multivariační analýza zjistila, že významnými prediktory úmrtí byly věk nad 60 let, systémová hypertenze, diabetes mellitus, obezita a dyslipidemie. Závěry: U nepřeživších účastníků studie s onemocněním covid-19 byly častěji přítomny systémová hypertenze, diabetes mellitus, obezita a dyslipidemie.

Background: Coronavirus disease (COVID-19) has caused significant morbidity and mortality. COVID-19 is more than a respiratory illness, it had multiple systemic effects such as myocarditis, arrhythmias, and venous thromboembolism. Aim of the study: We aimed to study the frequency of cardiovascular risk factors in patients with COVID-19 and the impact of these risk factors on short-term in-hospital outcome of patients newly discovered with COVID-19. Materials and methods: Cross-sectional analytic study conducted in Egypt on 200 patients (mean age of 44.2±12.7 years old) with positive polymerase chain reaction for COVID-19 recruited from different isolation hospitals. Patients were subjected to history taking, physical examination, and cardiac examination. The cardiovascular risk profile was studied among the enrolled patients. Twelve-lead electrocardiogram, routine laboratory tests, and computed tomography chest study were done for all patients. Patients were grouped into two groups A and B for survivors and non-survivors, respectively. Data were entered using the statistical package for social sciences, version 20.0 (SPSS Inc., Chicago, Illinois, USA). Results: The study was conducted on two hundred patients aged 20 to 79 years with male predominance. The study found that 181 patients (90.5%) survived (Group A) and 19 patients (9.5%) died (Group B). Multivariate analysis revealed that significant predictors of death were age above 60 years old, systemic hypertension, diabetes mellitus, obesity and dyslipidemia. Conclusions: Systemic hypertension, diabetes mellitus, obesity, and dyslipidemia were more prevalent in non-survivor patients with COVID-19.

• MeSH
• COVID-19 * complications   mortality   MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Cross-Sectional Studies MeSH
• Heart Disease Risk Factors * MeSH
• Aged MeSH
• Statistics as Topic MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Geographicals
• Egypt MeSH

Kontext: Koronarografické vyšetření má pro řádné vyhodnocení lézí na koronárních tepnách jisté limitace. Použití intravaskulárního ultrazvuku (intravascular ultrasound, IVUS) před perkutánní koronární intervencí (PCI) může odhalit významné stenózy, pomáhá zvolit vhodný stent a může upozornit na možné komplikace. Cílem studie bylo hodnotit důsledky použití IVUS na klinické a angiograficky potvrzené výsledky revaskularizace nechráněného kmene levé věnčité tepny (unprotected left main, ULM) nebo proximální levé přední sestupné větve (left anterior descending, LAD) pomocí stentu při ischemické chorobě srdeční (ICHS). Materiály a metody: Byla provedena prospektivní randomizovaná kontrolovaná studie s 60 pacienty se stabilní anginou pectoris nebo s akutním koronárním syndromem bez elevací úseku ST. Koronarografické vyšetření provedené na katetrizačním pracovišti egyptského Národního ústavu zdraví odhalilo významné ischemické postižení kmene levé věnčité tepny nebo proximální LAD. U pacientů byla indikována revaskularizace formou PCI. Perkutánní koronární intervence navigovaná koronárním IVUS byla provedena u 30 pa- cientů (skupina A), zatímco ve skupině B nebyl při PCI koronární IVUS použit. Účastníci studie byli sledováni po dobu šesti měsíců s cílem analyzovat primární nebo sekundární sledované parametry. Výsledky: Navigace pomocí IVUS byla spojena se statisticky významně větším minimálním průsvitem cév po implantaci stentu potvrzeným kvantitativní koronarografií (quantitative coronary angiography, QCA) (p = 0,001), větším průměrem stentu (p = 0,001) a další dilatací (p = 0,02). Srovnání obou skupin prokázalo, že navigace pomocí IVUS byla spojena se statisticky významně nižším výskytem trombózy stentu v cílových lézích, nefatálního infarktu myokardu ve vztahu k počtu cílových lézí, s nižšími počty revaskularizačních výkonů na cílových lézích i s nižšími celkovými počty závažných nežádoucích srdečních příhod (major adverse cardiac events, MACE) během šestiměsíčního sledování (p = 0,038 pro všechny uvedené parametry). Závěry: Provádění PCI s implantací stentu do ULM a proximální LAD, navigované pomocí IVUS, zlepšuje klinický výsledný stav se statisticky významně nižším výskytem MACE do 6 měsíců díky významně nižšímu riziku revaskularizace cílové léze a trombózy stentu. U pacientů s ischemickým postižením ULM nebo proximální LAD doporučujeme rutinní používání navigace pomocí IVUS při revaskularizaci implantací stentu.

Background: Coronary angiography has some limitations in the proper assessment of coronary artery le- sions. Intravascular ultrasound (IVUS) before percutaneous coronary intervention (PCI) can identify significant stenosis, select the appropriate stent and detect complications. The study aimed to evaluate the impact of intravascular ultrasound on clinical and angiographic outcomes after revascularization by stenting for patients with unprotected left main (ULM) or proximal left anterior descending (LAD) coronary artery disease (CAD). Materials and methods: A prospective randomized controlled study that was carried on sixty patients presented with stable angina or non-ST elevation acute coronary syndrome. Coronary angiography that was carried out at cardiac catheterization laboratory at the National Heart Institute in Egypt revealed significant left main or proximal LAD coronary artery disease. Patients were scheduled for revascularization by PCI. Percutaneous coronary intervention guided by coronary IVUS was done in thirty patients (Group A). Whe- reas, Group B included 30 patients in which PCI was not guided by IVUS. The patients were followed for six months to detect any primary or secondary endpoints. Results: IVUS guidance was associated with a significant higher post-stent minimal lumen diameter as found by quantitative coronary angiography (QCA) (p = 0.001), stent diameter (p = 0.001), and adjunct post-dilatation (p = 0.02). By comparing both study groups it was found that IVUS guidance was associated with significant lower rates of stent thrombosis in target lesions, non-fatal myocardial infarction related to target lesions, target lesion revascularization and all cause major adverse cardiac events (MACE) within 6 months of follow-up (p-value 0.038, for all). Conclusions: IVUS guided PCI during ULM and proximal LAD coronary artery stenting improves clinical out- come with significant lower rates of MACE at 6 months which is due to significant lower risk of target lesion revascularization and stent thrombosis. We recommended routine use of IVUS during revascularization by stenting in cases of ULM or proximal LAD CAD.

• MeSH
• Ultrasonography, Interventional * methods   instrumentation   MeSH
• Percutaneous Coronary Intervention methods   MeSH
• Middle Aged MeSH
• Humans MeSH
• Coronary Artery Disease * diagnostic imaging   therapy   MeSH
• Prospective Studies MeSH
• Randomized Controlled Trials as Topic MeSH
• Aged MeSH
• Statistics as Topic MeSH
• Stents MeSH
• Treatment Outcome MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Geographicals
• Egypt MeSH

INTRODUCTION: The J Project (JP) physician education and clinical research collaboration program was started in 2004 and includes by now 32 countries mostly in Eastern and Central Europe (ECE). Until the end of 2021, 344 inborn errors of immunity (IEI)-focused meetings were organized by the JP to raise awareness and facilitate the diagnosis and treatment of patients with IEI. RESULTS: In this study, meeting profiles and major diagnostic and treatment parameters were studied. JP center leaders reported patients' data from 30 countries representing a total population of 506 567 565. Two countries reported patients from JP centers (Konya, Turkey and Cairo University, Egypt). Diagnostic criteria were based on the 2020 update of classification by the IUIS Expert Committee on IEI. The number of JP meetings increased from 6 per year in 2004 and 2005 to 44 and 63 in 2020 and 2021, respectively. The cumulative number of meetings per country varied from 1 to 59 in various countries reflecting partly but not entirely the population of the respective countries. Altogether, 24,879 patients were reported giving an average prevalence of 4.9. Most of the patients had predominantly antibody deficiency (46,32%) followed by patients with combined immunodeficiencies (14.3%). The percentages of patients with bone marrow failure and phenocopies of IEI were less than 1 each. The number of patients was remarkably higher that those reported to the ESID Registry in 13 countries. Immunoglobulin (IgG) substitution was provided to 7,572 patients (5,693 intravenously) and 1,480 patients received hematopoietic stem cell therapy (HSCT). Searching for basic diagnostic parameters revealed the availability of immunochemistry and flow cytometry in 27 and 28 countries, respectively, and targeted gene sequencing and new generation sequencing was available in 21 and 18 countries. The number of IEI centers and experts in the field were 260 and 690, respectively. We found high correlation between the number of IEI centers and patients treated with intravenous IgG (IVIG) (correlation coefficient, cc, 0,916) and with those who were treated with HSCT (cc, 0,905). Similar correlation was found when the number of experts was compared with those treated with HSCT. However, the number of patients treated with subcutaneous Ig (SCIG) only slightly correlated with the number of experts (cc, 0,489) and no correlation was found between the number of centers and patients on SCIG (cc, 0,174). CONCLUSIONS: 1) this is the first study describing major diagnostic and treatment parameters of IEI care in countries of the JP; 2) the data suggest that the JP had tremendous impact on the development of IEI care in ECE; 3) our data help to define major future targets of JP activity in various countries; 4) we suggest that the number of IEI centers and IEI experts closely correlate to the most important treatment parameters; 5) we propose that specialist education among medical professionals plays pivotal role in increasing levels of diagnostics and adequate care of this vulnerable and still highly neglected patient population; 6) this study also provides the basis for further analysis of more specific aspects of IEI care including genetic diagnostics, disease specific prevalence, newborn screening and professional collaboration in JP countries.

• MeSH
• Immunoglobulin G * MeSH
• Administration, Intravenous MeSH
• Humans MeSH
• Infant, Newborn MeSH
• Educational Status MeSH
• Check Tag
• Humans MeSH
• Infant, Newborn MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Egypt MeSH
• Europe MeSH

Species of Acanthamoeba Volkonsky, 1931 are the commonest among free-living amoebae that are widespread in different water resources but with lacking phylogenetic data. This study aims at detecting molecular prevalence and genetic diversity of Acanthamoeba isolates in Kafrelsheikh Governorate, Egypt. Forty-eight water samples were collected from 12 swimming pools; four samples during each season over one year. Samples were filtered, cultivated on non-nutrient agar plates and examined microscopically. Polymerase chain reaction (PCR) and sequence analysis of positive samples targeting diagnostic fragment 3 (DF3) of the small subunit rRNA gene were done. Cultivation succeeded to detect 14 (29%) positive samples while PCR missed three positive samples. The obtained sequences were phylogenetically analysed. The phylogenetic tree was constructed for them with sequences of reference species from the NCBI database. The identified species were Acanthamoeba castellanii Douglas, 1930 (T4), A. astronyxis (Ray et Hayes, 1954) (T9) and A. hatchetti Sawyer, Visvesvara et Harke, 1977 (T11). The prevalence of species of Acanthamoeba was higher during summer and fall. Therefore, the control of the presence of Acanthmoeba spp. in swimming pools needs immediate, effective and practical measures to prevent and control infection with species of Acanthamoeba.

• MeSH
• Acanthamoeba * genetics   MeSH
• Phylogeny MeSH
• Genotype MeSH
• Swimming Pools * MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Egypt MeSH

Introduction: Nephrotic syndrome (NS) might be caused by a kidney disorder or it can be a secondary disease. Untreated or resistant to treatment, NS stimulates glomerular damage that reduces the kidney function. This reduction leads to the end stage of renal failure. Therefore, it is very important to diagnose NS early, with the aim of inhibiting or lessening its associated morbidity and mortality. Methods: Gene polymorphism analysis for the three genes eNOS 27 bp VNTR, GSTP1 and IL-10(1082 G/A) were checked in 98 children with NS and 101 control subjects. Results: eNOS 27 bp VNTR genotypes and alleles are significantly different in the group of 98 children with NS compared to the 101 control subjects. The frequencies of ab and bb genotypes are significantly lower in patients than in the control group (ab: 17.2% vs. 22.8%; OR: 0.19; 95% CI: 0.06-0.58; p = 0.0026 & bb: 54.7% vs. 70.3%; OR: 0.19; 95% CI: 0.07-0.5; p = 0.0004). However, neither GSTP1 nor IL-10(1082 G/A) genotypes showed any significant difference in both groups. Conclusions: eNOS 27 bp VNTR gene might be considered as an independent risk factor in the early prediction of nephrotic syndrome incidence, which may help prevent/reduce the occurrence of other complications associated with the late diagnosis and treatment of the disease.

• MeSH
• Child MeSH
• Genotyping Techniques MeSH
• Humans MeSH
• Nephrotic Syndrome * epidemiology   genetics   MeSH
• Polymorphism, Genetic genetics   MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Geographicals
• Egypt MeSH

Chemical pollution of water is the contamination of water by foreign matter that deteriorates the quality of the water. Pollution of water by heavy metals are dangerous because they tend to cause Bioaccumulation that means an increase in the concentration of a chemical in a biological organism over time, compared to the chemical's concentration in the environment. Chemical pollution of Manzala lake was studied in 4 main localities, Kapoty, Bashtier, Mataryia and Gamil areas which receives high load of sewage, agricultural and industrial wastes from different sources. Heavy metals, such as Zn, Pb, Cd and Hg were estimated in water and fish samples, to reveal high pollution of lake Manzala with such toxic elements, where Zn, reached 800μg/L. Pb,195 μg/L. Cd 45 μg/L and. Hg, 5000 μg/L in water samples.

• MeSH
• Celiac Disease diet therapy   MeSH
• Nutritional Physiological Phenomena MeSH
• Humans MeSH
• Heavy Metal Poisoning MeSH
• Water Pollution adverse effects   MeSH
• Check Tag
• Humans MeSH
• Geographicals
• Egypt MeSH

BACKGROUND: Little information is available on the official postgraduate and subspecialty training programs in movement disorders (MD) in Europe and North Africa. OBJECTIVE: To survey the accessible MD clinical training in these regions. METHODS: We designed a survey on clinical training in MD in different medical fields, at postgraduate and specialized levels. We assessed the characteristics of the participants and the facilities for MD care in their respective countries. We examined whether there are structured, or even accredited postgraduate, or subspecialty MD training programs in neurology, neurosurgery, internal medicine, geriatrics, neuroradiology, neuropediatrics, and general practice. Participants also shared their suggestions and needs. RESULTS: The survey was completed in 31/49 countries. Structured postgraduate MD programs in neurology exist in 20 countries; structured neurology subspecialty training exists in 14 countries and is being developed in two additional countries. Certified neurology subspecialty training was reported to exist in 7 countries. Recommended reading lists, printed books, and other materials are the most popular educational tools, while courses, lectures, webinars, and case presentations are the most popular learning formats. Mandatory activities and skills to be certified were not defined in 15/31 countries. Most participants expressed their need for a mandatory postgraduate MD program and for certified MD sub-specialization programs in neurology. CONCLUSION: Certified postgraduate and subspecialty training exists only in a minority of European countries and was not found in the surveyed Egypt and Tunisia. MD training should be improved in many countries.

• MeSH
• Accreditation statistics & numerical data   MeSH
• Curriculum statistics & numerical data   MeSH
• Humans MeSH
• Neurology education   statistics & numerical data   MeSH
• Movement Disorders * MeSH
• Health Care Surveys statistics & numerical data   MeSH
• Education, Medical, Graduate statistics & numerical data   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Egypt MeSH
• Europe MeSH
• Tunisia MeSH