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Maple Syrup Urine Disease (MSUD, OMIM# 248600) is an autosomal recessive inborn error of metabolism characterized by elevated branched chain amino acids (BCAA) leucine/isoleucine and valine in blood of affected children. The phenotypic and genotypic spectrum of MSUD is largely unreported in Egypt. We recruited ten patients (4 males/6 females, 2weeks-12years) from nine unrelated families with clinical and biochemical evidence of MSUD. We performed Sanger sequencing for the three most-commonly responsible genes: BCKDHA, BCKDHB and DBT and conducted exome sequencing for unresolved cases. Through Sanger sequencing, we detected eight homozygous pathogenic/likely pathogenic variants (four in BCKDHB, three in BCKDHA and one in DBT gene) in eight different families. The proband of family VI, who had no significant genetic findings by Sanger, had a peculiar phenotype and atypical radiological findings. His exome sequencing revealed a previously reported homozygous likely pathogenic variant in the RARS2 gene (NM_020320.5:c.1026G > A;p.(Met342Ile)) causing the mitochondrial-encephalopathy disorder pontocerebellar hypoplasia, type 6 (OMIM# 611523). Furthermore, the copy-number-variant analysis of the exome data revealed a biallelic duplication affecting exons 2–6 of the BCKDHB gene (GRCh38: Chr.6-g.80127496:80171441dup) evaluated as variant of uncertain significance but expected to cause a breakpoint and may disrupt gene function, which can explain the markedly elevated BCAA levels in the patient's blood. In conclusion, we expanded the genotypic and phenotypic spectrum of the disease and showed that aggressive intervention with specific treatment in the first few days of life resulted in normal development even in a developing country setting. Inclusion of MSUD in the national newborn screening program in Egypt is highly recommended. [ABSTRACT FROM AUTHOR]

Lung cancer is a serious health and life issue, with the fastest-growing incidence and fatality rates worldwide. It is now clear that inflammation is a key factor involved in all aspects of carcinogenesis, notably lung cancer development. Genetic changes, including polymorphisms in inflammatory genes, are supposed to be a significant cause of increased lung cancer risk. The main idea of this research was to disclose the linkage between both IL-6 rs1800795 and IL-1β rs16944 variants and susceptibility to non-small-cell lung cancer (NSCLC) in Egyptians. This case–control design was composed of 127 cases and 138 controls, which were genotyped using the ARMS-PCR technique. To examine the NSCLC susceptibility under various genetic models, the odds ratio (OR) and 95% confidence intervals (CIs) were determined by logistic regression. Rs1800795 of the IL-6 gene was linked to higher odds of NSCLC under the allele model (adjusted, OR 2.28; 95% CI 1.2–4.33; p = 0.011). In the genetic models, IL-6 rs1800795 elevated the odds of NSCLC, while IL-1β rs16944 decreased the odds of NSCLC. Stratification analysis showed that IL-6 rs1800795 greatly increased the NSCLC risk in females and adenocarcinoma subtypes, whereas IL-1β rs16944 largely decreased the NSCLC risk for males, patients aged < 55, and nonsmokers. Regarding clinical data, the IL-6 variant was remarkably correlated with tumor size. This work primarily established that IL-6 and IL-1β variants have a great impact on NSCLC development in the Egyptian population; thus, it may be a supportive guide for earlier NSCLC prevention. [ABSTRACT FROM AUTHOR]

Background: Accurate staging is necessary for predicting hepatocellular carcinoma (HCC) prognosis and guiding patient management. The Barcelona Clinic Liver Cancer (BCLC) staging system has limitations due to heterogeneity observed among patients in BCLC stages B and C. In contrast, the Hong Kong Liver Cancer (HKLC) staging system offers more aggressive treatment strategies. Aim: To compare the prognostic performance of HKLC and BCLC staging systems in Egyptian patients with HCC. Methods: We conducted a retrospective study at the National Liver Institute, Menoufia University, Egypt, on 1015 HCC patients. Data was collected from patients' medical records over 10 years (from 2008 to 2018). The BCLC and HKLC stages were identified, and Kaplan-Meier survival analysis was used to compare patients' overall survival rates within each staging system. Additionally, we evaluated the comparative prognostic performance of the two staging systems. Results: Hepatitis C was identified as the underlying etiology in 799 patients (78.7%), hepatitis B in 12 patients (1.2%), and non-viral causes in 204 patients (20.1%). The survival analysis demonstrated significant differences across the various stages within both the BCLC and HKLC systems. The receiver operating characteristic (ROC) curves indicated a marginally superior performance of the HKLC system in predicting survival at 1, 2, and 3 years compared to the BCLC system. Furthermore, the HKLC staging provided a slightly enhanced prognostic capability, particularly for patients classified under BCLC stages B and C, suggesting a potential survival benefit. Conclusion: HKLC classification had a slightly better prognostic performance than BCLC staging system and may offer a survival advantage for certain patients with HCC in BCLC stage B and C HCC cases. [ABSTRACT FROM AUTHOR]

Background: High prevalence of inappropriate antibiotic use in different sectors of the community indicates a possible strong influence of social and cultural context, which may be influenced by social determinants of health and thereby affecting individuals' health-related behavior, including antibiotic use. And such health-related behavior is largely determined by individuals' health literacy. Objective: The purpose of this research was to examine the relationship between the Egyptian population's health literacy, antibiotic use, and antibiotic knowledge. Method: In Egypt, researchers used a cross-sectional study design, between the period of January and March 2024 using validated questionnaires and recruited a convenient sample of adults from seven governorates representing different geographic areas, and socioeconomic and educational backgrounds with the help of the validated questionnaires the HLS-EU-Q16, a shortened version of the European Health Literacy Survey Questionnaire (derived from the World Health Organization's Antibiotic Resistance: Multi-Country Public Awareness Survey) and, familiarity with drugs and understanding of antibiotic resistance via online methods and face-to-face interviews. Results: The survey included a participation of 500 persons in total. The participants' age distribution indicated that 28.8% (n = 144) were aged 18–24, while 27.4% (n = 137) were within the 25–34 age group. Moreover, a total of 274 participants, accounting for 54.8% of the sample, described themselves as female. Significantly, 60.7% of the patients indicated acquiring antibiotics without a prescription. The evaluation of health literacy (HL) levels among the participants revealed that 36.2% had problematic HL, while 8.4% showed inadequate HL. A strong positive link was found between the scores of antibiotic knowledge and the scores of HL (R = 0.876; P-value = 0.001). Conclusion: Overall, it is imperative to implement awareness-raising curricula and public health education initiatives without delay. Furthermore, it is highly advised to implement public health awareness initiatives about the appropriate use of antibiotics, alongside national policies aimed at regulating the availability and prescription of antibiotics. [ABSTRACT FROM AUTHOR]

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Background: Fibromyalgia is a chronic, disabling disorder of widespread musculoskeletal pain. It is generally considered a stress-related syndrome. Healthcare workers are prone to mental and physical stress due to due to excessive work burdens, long working hours, and a lack of balance between work and social life. Objective: The aim of this study was to examine the prevalence of fibromyalgia and its predictors among Egyptian physicians. Methods: Six hundred and ninety-one Egyptian physicians completed an online survey which included a self-reported fibromyalgia rapid screening tool (FiRST) as well as demographic (sex and age), health-related (chronic illnesses if any), and employment data (workday length, specialty, and employer). Logistic regression was performed to explore possible predictors of fibromyalgia. Results: Fibromyalgia was observed in 13.2% of participants, with a female to male ratio of 3.8:1. Predictors of FM in this cohort included the following: female sex (odds ratio (OR) 2.2, 95% confidence interval (CI) 1.2–3.9, p = 0.014), age 41–50 years (OR 3.8, 95% CI 1.5–9.6, p = 0.005), concomitant chronic illness: endocrinopathies (other than diabetes mellitus) (OR 2.69, 95% CI 1.09–6.64, p = 0.035), musculoskeletal disorders (OR 5.60, 95% CI 2.96–10.6, p < 0.001), autoimmune disorders (OR 3.61, 95% CI 1.69–7.73, p = 0.002), employment at a Ministry of Health Healthcare Facility (OR 1.8, 95% CI 1.1–3.1, p = 0.013), and a workday length of ≥ 13 h (OR 2.4, 95% CI 1.1–5.3, p = 0.038). Physicians in surgical specialties were less likely to suffer from FM (OR 0.47, 95% CI 0.24–0.94, p = 0.033). Conclusion: Egyptian physicians have higher fibromyalgia prevalence than the general population. Demographic, health-related, and professional predictors of FM were identified in this cohort. [ABSTRACT FROM AUTHOR]

Egypt has long been overwhelmed by the hepatitis C virus (HCV) infection, and it used to be the country with the world's highest prevalence rates. The disease had been a significant public health problem, affecting millions of Egyptians and posing severe economic and social challenges. By the early 2000s, it was estimated that around 10% of the Egyptian population was infected with HCV. However, in recent years, with the availability of direct-acting antiviral therapies, the country has made enormous steps in combating this public health threat. The combination of innovative health strategies and political will enabled Egypt to establish a successful model of care for HCV management and to be the first country to eliminate hepatitis C, setting a model for the rest of the world. In 2023, Egypt became the first country to fulfill the World Health Organization's set programmatic criteria of reduction of hepatitis C incidence and mortalities to levels close to elimination of disease or achieve the "gold tier" status on the path to disease elimination. [ABSTRACT FROM AUTHOR]

Background: Dementia is a pressing problem for families and society. In 2019, a total of 57.4 million people worldwide were estimated to be living with dementia, and this number will almost double every 20 years, especially in Africa and the Middle East. This study aimed to investigate knowledge about dementia among the Egyptian population. A cross-sectional online survey was conducted among a sample of adult Egyptians using a socio-demographics data sheet and a designed dementia knowledge questionnaire. Results: Nearly one-third (33.4%) had a poor knowledge score. The items most often answered incorrectly were the sudden onset of cognitive problems as characteristic of dementia (59.3%). The highest percentage of good knowledge was in the manifestations and prevention domains (62.20% and 67.18%, respectively). On the other hand, the lowest rate of good knowledge was in the treatment and life impact domains (35.23% and 25.70%, respectively). Not working in the medical field (OR 2.656, 95% CI: 1.504–4.688, p < 0.001), had no contact with dementia patients (OR 1.910, 95% CI: 1.229–2.970, p = 0.004), no previous knowledge on dementia (OR 3.184, 95% CI: 1.797–5.642, p < 0.001), or never heard about dementia "Marad Alkharaf" (OR 6.385, 95% CI: 4.127–9.878, p < 0.001) were significantly associated with poorer dementia knowledge. Conclusion: The findings of our study indicated variable levels of knowledge of dementia among Egyptians. Our recommendation is to encourage conducting campaigns for raising public awareness about dementia and through media that has an important and widespread effect in reaching the Egyptian population. [ABSTRACT FROM AUTHOR]

This paper aims to identify the constrains faced by female entrepreneurs in Egypt. This study also intends to examine the influence of formal and informal institutional factors on women's entry into entrepreneurship in Egypt. In addition, to explore the factors enable women entrepreneurs to overcome the barriers they may face. The qualitative research approach was adopted in the study to explore the challenges experienced by Egyptian female entrepreneurs. Purposeful sampling was employed and twenty-five (25) women entrepreneurs were selected from five Egyptian governorates to conduct semi-structured interviews to collect primary data. The findings indicated that the main constraints faced Egyptian women entrepreneurs arise from difficulty in raising capital, socio-culture commitments, sexual harassment, work-family conflict and lack of managerial skills. The study found factors such family-husband support, religious values, personal traits and technological skills are crucial for overcome constraints faced by women entrepreneurs. The study recommends creating a funding program targeting female entrepreneurs and raise the awareness about the importance of women entrepreneurship as well as take necessary actions to prevent sexual harassment phenomenon. Minimal research has examined female entrepreneurship in Egypt. Therefore, this study offers valuable insights of constraints faced by women entrepreneurs in Egypt. The study contributes to the women's entrepreneurship literature from the perspective of an Arab Islamic developing country. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus (DM) patients are prone to influenza infection. Seasonal vaccination is the most effective method to prevent influenza. Assessing the influenza coverage and the knowledge and attitude of patients toward it will help in raising the coverage and decreasing the complications. Objectives: To detect the level of influenza vaccination coverage among people with type 2 diabetes mellitus (T2DM) and assess the knowledge about influenza infection and attitude toward influenza vaccine among those patients. Methods: We conducted a cross-sectional study in the diabetes outpatient clinics at Zagazig University hospitals. The study included 327 diabetic patients. It took six months, from February to July 2023. A structured questionnaire was used to assess knowledge, attitudes, and practices regarding seasonal influenza vaccination and factors that may affect them. Results: The mean age of participants was 55.2 years; most of them were female (63.3%). The vaccination coverage was only 23.9%. Sufficient knowledge was reported (64.8%), and a positive attitude toward vaccination among those who had heard about it was reported (69.6%). The main cause of non-vaccination was that they didn't hear about the vaccine (67.8%), while the main cause of vaccination was a doctor's advice (62.8%). After logistic regression, sufficient knowledge and longer disease duration were found to be statistically significant predictors for vaccination (odds ratio 2.117, 1.081 respectively). Conclusions: The influenza vaccination rate among T2DM patients is below the optimal level. Overall, knowledge and attitude toward the influenza vaccine among diabetic patients should be raised. [ABSTRACT FROM AUTHOR]

Recent political conflicts in the Middle East have led to a significant increase in refugees’ numbers in Egypt, causing a substantial population increase in neighborhoods like Al-Rehab City and the 6th of October. The resulting semi-hybrid communities have had a notable impact on travel behavior in these areas. Due to the economic impact that is affected by this travel behavior, this study aims to investigate the commuting behaviors and preferences of individuals in Cairo and Alexandria, focusing on demographic groups such as Egyptians and migrants. The research addresses two main questions: (1) What significant variations exist in commuting characteristics between Egyptians and migrants based on their social and cultural backgrounds, and what variables influence the travel behavior of these two groups? (2) What factors relate to public transport use, that map all aspects of work/home trip choices that affect the daily commuting distances? Initially, to find the significant differences between both test groups, a questionnaire was designed and distributed through a sample of 1,810 face-to-face interviews (1,193 in Cairo and 617 in Alexandria). The questionnaire comprised 39 questions, these questions are covered in six sections that cover the following aspects: sociodemographic and household profiles, mobility habits, commuting habits and preferences, perceptions of public transportation, ridesharing, and housing. In the data analysis stage, a non-parametric statistical test “The Mann–Whitney U test” is used to determine if there is a difference between both groups according to certain variables. To examine the relationship between subjective public transport utilization and commuting trip generation, a multivariate Ordinary Least Squares (OLS) model was applied. The model application provides valuable insights for the formulation of impactful urban and mobility systems. Drawing a road map to help policymakers in enhancing public transport infrastructure to better match the preferences of commuters, ultimately fostering safer and more gratifying travel experiences. [ABSTRACT FROM AUTHOR]

Background: Despite the increasing incidence of colorectal cancer (CRC) in the Egyptian population, it still seems that there is a significant lack of awareness regarding the disease. This study aimed to assess the Egyptian population's awareness of CRC regarding its risk factors, the screening procedures, and the appropriate responses to its diagnosis. Method: A cross-sectional study was conducted in Egypt between July 2022 and March 2023 and recruited a convenient sample of adults from seven governorates representing different geographic areas, and socioeconomic and educational backgrounds with the help of the validated Bowel Cancer Awareness Measure (CAM) version 2.1. The modified Arabic questionnaire was validated through a pilot study including 30 patients. Then it was presented through a Google form before being shared via online methods and face-to-face interviews. The questionnaire provided both numerical and categorical data, which were analyzed accordingly. The Chi-square, the Fisher exact, and the Man-Whitney test were used to compare colorectal cancer poor and good knowledge groups. Logistic regression analysis was conducted to predict the factors that affected the awareness level of the study population. Results: Nine hundred forty individuals participated in the survey. Their ages ranged from 18 to 86 years old, with an average of 37.38 ± 12.22 years. The mean Knowledge score was 14.29 ± 7.05 out of 37 with most of our participants (71%) having poor knowledge about CRC. Most of the participants (64.1%) chose colonoscopy as the best screening modality, followed by an abdominal CT (27.8%), and fecal occult blood (15.5%). The study revealed significant differences between participants with good and poor knowledge of colorectal cancer. (78.5%) of participants with good CRC knowledge lived in cities, (85.4%) attained university or higher educational level, and (87.2%) of them were nonsmokers (p < 0.05%). Conclusion: In general, there was a lack of awareness about Colorectal cancer among the Egyptian population especially among rural and lower educational levels, and more health education campaigns are required to enhance CRC prevention efforts in Egypt. [ABSTRACT FROM AUTHOR]

Background: Egypt faces a significant public health burden due to chronic liver diseases (CLD) and peptic ulcer disease. CLD, primarily caused by Hepatitis C virus (HCV) infection, affects over 2.9% of the population nationwide, with regional variations. Steatotic liver disease is rapidly emerging as a significant contributor to CLD, especially in urban areas. Acid-related disorders are another widespread condition that can significantly impact the quality of life. These factors and others significantly influence the indications and findings of gastrointestinal endoscopic procedures performed in Egypt. Aim: We aimed to evaluate the clinico-demographic data, indications, and endoscopic findings in Egyptian patients undergoing gastrointestinal endoscopic procedures in various regions of Egypt. Methods: This study employed a retrospective multicenter cross-sectional design. Data was collected from patients referred for gastrointestinal endoscopy across 15 tertiary gastrointestinal endoscopy units in various governorates throughout Egypt. Results: 5910 patients aged 38–63 were enrolled in the study; 75% underwent esophagogastroduodenoscopy (EGD), while 25% underwent a colonoscopy. In all studied patients, the most frequent indications for EGD were dyspepsia (19.5%), followed by hematemesis (19.06%), and melena (17.07%). The final EGD diagnoses for the recruited patients were portal hypertension-related sequelae (60.3%), followed by acid-related diseases (55%), while 10.44% of patients had a normally apparent endoscopy. Male gender, old age, and the presence of chronic liver diseases were more common in patients from upper than lower Egypt governorates. Hematochezia (38.11%) was the most reported indication for colonoscopy, followed by anemia of unknown origin (25.11%). IBD and hemorrhoids (22.34% and 21.86%, respectively) were the most prevalent diagnoses among studied patients, while normal colonoscopy findings were encountered in 18.21% of them. Conclusion: This is the largest study describing the situation of endoscopic procedures in Egypt. our study highlights the significant impact of regional variations in disease burden on the utilization and outcomes of GI endoscopy in Egypt. The high prevalence of chronic liver disease is reflected in the EGD findings, while the colonoscopy results suggest a potential need for increased awareness of colorectal diseases. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the relationship between gratitude and prosocial tendency and the potential mediating role of psychological resilience in this association. Six hundred and seventy-six Saudi Arabia and Egyptian students completed the Gratitude Scale, Prosocial tendency Scale and Psychological Resilience Scale. The results showed no significant differences in gratitude, prosocial tendency and psychological resilience according to culture or gender in both countries. Moreover, gratitude positively correlated with prosocial tendency and psychological resilience. Furthermore, the results revealed that psychological resilience significantly mediated the association between gratitude and prosocial tendency. We conclude that gratitude predicts prosocial tendency and psychological resilience plays a mediating role in this association among Arab societies. [ABSTRACT FROM AUTHOR]

Background: Body image appreciation is an important psychological aspect for all individuals of all ages which affects their psychological, personal, and social well-being. Objectives: Examining the relationship between disordered eating tendencies, body appreciation, body mass index (BMI), and emotional distress among individuals who follow and seek psychological services from the non-profit entitative Egyptian eating disorders initiative EEDI and an online therapy platform. Methods: A cross-sectional study including 301 healthy participants with no past medical or psychiatric history was conducted. Participants completed an online survey including demographic data, BMI, and three measures: The Eating Attitudes Test (EAT-26), the Body Appreciation Scale (BAS), and the Depression Anxiety and Stress Scale (DASS-21) questionnaires. Results: Participants with disordered eating tendencies — according to EAT-26 — had lower BAS scores (p < 0.001) and higher DASS depression, anxiety, and stress scores (p < 0.001). EAT-26 was negatively correlated with age (p = 0.003) and BAS (p < 0.001). Meanwhile, it was positively correlated with the three DASS scales (p < 0.001). BAS was negatively correlated with body mass index and the three DASS scales (p < 0.001). Conclusion: Body appreciation decreases with increased disordered eating tendencies and BMI. Depression, anxiety, and stress are associated with a decrease in body appreciation. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) represented an international health risk. Variants of the interferon-induced transmembrane protein-3 (IFITM3) gene can increase the risk of developing severe viral infections. This cross-sectional study investigated the association between IFITM3 rs12252A>G single nucleotide polymorphism (SNP) and COVID-19 severity and mortality in 100 Egyptian patients. All participants were subjected to serum interleukin-6 (IL-6) determination by ELISA and IFITM3 rs12252 genotyping by real-time polymerase chain reaction. Of all participants, 85.0% had the IFITM3 rs12252 homozygous AA genotype, whereas 15.0% had the heterozygous AG genotype. None of our participants had the homozygous GG genotype. The IFITM3 rs12252A allele was found in 92.5% and the G allele in only 7.5%. There was no significant association (p > 0.05) between the IFITM3 rs12252 SNP and COVID-19 severity, intensive care unit (ICU) admission, or IL-6 serum levels. The heterozygous AG genotype frequency showed a significant increase among participants who died (32.0%) compared with those who had been cured (9.3%). The mutant G allele was associated with patients' death. Its frequency among cured participants was 8.5%, whereas in those who died was 24.2% (p = 0.024) with 3.429 odds ratio [95% confidence interval: 1.1–10.4]. In conclusion, this study revealed a significant association between the G allele variant of IFITM3 rs12252 and COVID-19 mortality. However, results were unable to establish a significant link between rs12252 polymorphism, disease severity, ICU admission, or serum IL-6 levels. [ABSTRACT FROM AUTHOR]

Background: The high rates of infection and mortalities initially caused by COVID-19, made anxiety and fear very common. With the increase of vaccination coverage, it is expected to detect changes in risk perception and fear of COVID-19, especially with the emergence of what so called "Pandemic Fatigue". The aim of this study was to assess COVID 19 risk perception after the vaccination era. Methods: This is a cross-sectional analytical study, using an online questionnaire including socio-demographic questions and COVID-19 risk perception questions. Results: The questionnaire was filled by 509 participants. Sociodemographic characters of the participants didn't affect the COVID-19 risk perception. The mean and median perceived efficacy scores were significantly higher in participants with no prior history of COVID-19 infection. Participants with positive attitude towards COVID-19 vaccine had significantly higher risk perception. Conclusion: COVID-19 risk perception is still query and not fully understood. This necessitates more studies to be conducted to explore it among different groups which may relate it to different determinants. Social media is the main source of knowledge among participants and should be professionally used for enhancing positive attitudes towards COVID-19 vaccination. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) represents a significant health challenge in Egypt, yet there exists limited understanding regarding the knowledge, attitudes, and physical activity levels associated with CVD. These factors play a pivotal role in developing effective prevention and management strategies. Hence, this cross-sectional study aimed to evaluate Egyptian adults' knowledge, attitudes, and physical activity (KAP) levels. Methods: Data were collected using a previously validated questionnaire encompassing demographic characteristics, CVD knowledge (including risk factors and symptoms), attitudes toward CVD, and self-reported physical activity levels. The survey was distributed among social media channels, and trained researchers administered the questionnaire via face-to-face interviews with adult patients with and without CVD admitted to Cairo University Hospital clinics. Results: The study involved 591 participants, of whom 21.7% had CVD. Overall, participants exhibited poor knowledge regarding CVD, with a mean score of 21 ± 7 out of 40, equivalent to 52.5%. Attitudes toward CVD were moderate, with a mean score of 66.38 ± 8.7 out of 85, approximately 78%. Physical activity levels per week were also moderate, averaging 1188 MET-min with a range of 1121–18,761. Subgroup analysis revealed that individuals with CVD had lower average knowledge, attitude, and physical activity levels than those without CVD. Working in the healthcare field was a predictor of higher knowledge score (standard error (SE) 5.89, 95% confidence interval (CI) 4.61 to 7.17, P < 0.001), while those with CVD and smokers were predictors of lower attitude score (SE -4.08, 95% CI -6.43 to -1.73, P < 0.001) and (SE -2.54, 95% CI -4.69 to -0.40, P = 0.02), respectively. Conclusion: The study findings highlight a significant disparity in knowledge, attitudes, and physical activity levels related to CVD in Egypt. Targeted interventions aimed at improving awareness, fostering positive attitudes, and promoting physical activity among individuals at risk for CVD are crucial for effective prevention and management. [ABSTRACT FROM AUTHOR]

Background: Hereditary angioedema (HAE) is a hereditary illness represented by repeated bouts of submucosal or subcutaneous edema. Types of HAE includes; HAE with deficient C1-inhibitor (type 1), HAE with dysfunctional C1-inhibitor (type 2), and HAE with normal C1-inhibitor. Data on the epidemiology of HAE in Egypt are limited. Therefore, we aimed to characterize HAE in Egyptian children, identify the morbidity, and clarify HAE's different clinical and laboratory presentations. Methods: In this cross-sectional study, we enrolled pediatric patients diagnosed with HAE according to the international hereditary angioedema WAO/EAACI guidelines. We gathered laboratory data on patients' mean serum C1 esterase inhibitor (C1-INH) level and activity, C4, and IgE levels. Results: We included 18 HAE patients (14 females and 4 males). They were between the ages of 6 and 18 years. The mean age upon confirmation of diagnosis was 8.4 ± 2.4 years. The mean time required to correctly diagnose HAE was 3.2 ± 1.8 years. We detected type I in 15 cases and type II in three cases. Eleven patients had a family member with HAE. In terms of previous misdiagnoses, 50% of patients were diagnosed with allergic angioedema. The median annual frequency of episodes was 17. The mean HAE attack time was 2.9 ± 1.5 days. Edema was most typically found in the face and abdomen. Trauma was the main triggering factor. We detected a significant direct relationship between severity of attack and C1-INH activity level. Conclusions: This research adds a considerable clinical information about children with HAE. According to current results, there is a considerable underdiagnosis of HAE in Egypt. The detection and management of HAE can be improved by screening the relatives of HAE patients. [ABSTRACT FROM AUTHOR]

Background: The development of the nursing profession depends significantly on how communities perceive it. This study aims to identify the views and attitudes of Arabic communities, specifically those in Sudan, Yemen, and Egypt, toward the nursing profession. Methods: A descriptive comparative study was used to identify the perception of Arabic communities (Sudan, Yemen, and Egypt) toward the nursing profession. The study was conducted in three Arabic countries (Sudan, Yemen, and Egypt) using an online approach by sending the link of questions to the targeted population using emails, WhatsApp, and social media. There were 529 participants from the three Arabic countries. The study was analyzed by SPSS software using descriptive and inferential statistics. Results: A majority (75.6%) of the participants were aged <40 years, with most (82.9%) being between 21 and 30 years of age. There was a generally positive perception toward the nursing profession among these communities: 97.6% of Sudanese, 94.9% of Yemenis, and 96.1% Egyptian. There was a borderline statistical significance between the Sudanese and Egyptians' age and their perception toward their profession. Gender is the only factor influencing the perception in Sudan and Egypt, and while women have a higher positive perception in Egypt, men have a higher positive perception in Sudan. Conclusion: Overall, the perception of Sudanese, Yemeni, and Egyptian communities toward the nursing profession is acceptable. The only influencing factor on the level of perception was Egyptian females who have high positive perception toward the nursing profession and Sudanese males who have high positive perception toward nursing profession We recommend further research to assess the perception toward nursing from different sociocultural backgrounds and on a larger sample size. [ABSTRACT FROM AUTHOR]

Background: Self-medication (SM) is a rising public health issue, especially in developing countries. It can be associated with various problems such as the delayed seeking of medical advice, drug interactions, and serious events such as antimicrobial drug resistance. We aimed to evaluate the Egyptian general population's knowledge, attitudes, and practices of SM. Methods: We employed a cross-sectional design between February 7th and March 8th, 2023 using a self-administered questionnaire available in Arabic. The questionnaire was developed based on previous studies and included four domains: sociodemographic data, knowledge, attitude, and practice of SM. We utilized both online (Google Forms) and paper surveys, utilizing convenience and snowball sampling methods. Data were analyzed using R Statistical Software (v4.1.3; R Core Team 2022). Results: 1630 Egyptian individuals (838 females and 792 males) from the seven provinces were enrolled, with a median age of 25 years (IQR: 22–40). Around 55.97% and 48.28% of the participants had good knowledge and favorable attitudes regarding SM respectively, while 62.8% had practiced SM in the previous three months. The most frequently used medications were painkillers (60.74%) followed by antibiotics (32.13%) and antipyretics (28.61%). The pharmacist's recommendation was the source of SM for 53.61% while 31.53% used old medications at home. Most participants (59.08%) practiced SM because they thought they had simple or minor symptoms. The multivariate regression analysis revealed that females had significantly higher knowledge of SM than males (aOR: 2.10; 95%CI: 1.64—2.71; p-value < 0.001), with no significant differences in practice (aOR: 1.24; 95%CI: 0.99 – 1.56; p-value = 0.065). Individuals working or studying in the medical field were significantly more knowledgeable about SM (aOR: 4.30; 95%CI: 3.27–5.69; p-value < 0.001) and more likely to practice SM (aOR: 1.65; 95%CI: 1.26–2.17; p-value < 0.001). The odds of SM decreased with favorable attitudes (aOR: 0.44; 95%CI: 0.36–0.55; p-value < 0.001) while surprisingly, knowledge level was not significantly contributing to SM practice (aOR: 1.15; 95%CI: 0.90–1.48; p-value = 0.268). Conclusions: SM is prevalent in Egypt, highlighting the importance of raising awareness and encouraging physician consultation as a priority. Governments, healthcare organizations, and educational institutions need to collaborate to provide the necessary support and resources. [ABSTRACT FROM AUTHOR]

Background: MicroRNAs (miR) are small sequence of nucleotides that can affect multiple genes involved in the hepatitis C virus (HCV) life cycle and disease development. The purpose of the present study was to investigate the clinical significance of serum microRNA profiles in a cohort of Egyptian patients with chronic HCV infection before and after combined sofosbuvir and daclatasvir treatment, as well as to gain a better understanding of the exact interaction mechanism in HCV transcriptional activity via differentially expressed miRNAs. For 12 weeks, 50 patients were eligible for and received sofosbuvir (400 mg daily) and daclatasvir (60 mg daily) treatment. Each patient's blood was obtained twice: once before therapy began and again three months afterwards. Results: The current study found that serum levels of circulating miR-122, miR-221, miR-23a, miR-125, miR-217, miR-224, and miR-181a were high in HCV pre-treatment patients, but after 12 weeks of direct-acting antiviral (DAAs) treatment, there was a statistically significant reduction in expression levels of miR-122, miR-221, miR-23a, miR-125, miR-217, and miR-224 (p < 0.001). There is no statistical significance for miR-181a. Conclusion: The key differentially expressed microRNAs before and after the direct-acting antiviral (DAA) regimen were connected to the dynamics of chronic HCV infection, suggesting their potential as predictive biomarkers for HCV clearance after sofosbuvir and daclatasvir therapy. [ABSTRACT FROM AUTHOR]

Background: Personalized asthma medicine research identifies critical genes like ADRB2 and ADH5 that affect disease and treatment outcomes, necessitating a deeper exploration of these genetic influences on asthma prevalence and management in Egyptian children. This study aimed to examine the relationship between asthma control and specific genetic variants in Egyptian children, focusing on four significant SNPs within four key genes. Methods: A cross-sectional genetic study was conducted between December 2020 and May 2021 at two hospitals affiliated with Al-Azhar University to assess gene polymorphisms in adolescent asthmatic patients. Blood samples were taken from participants, with portions dedicated to DNA extraction and serum level measurements. The extracted DNA was then genotyped using the real-time PCR technique, and specific genotypes were identified based on their fluorescence characteristics. Results: A total of 93 subjects were enrolled in the study. Cases (asthmatic children) had a significantly higher BMI than controls—healthy children—(33.65 ± 3.88 vs. 21.10 ± 3.48, p < 0.001). A notable distinction was observed in residence, with 30.6% of cases from urban areas versus 85.7% in controls (p < 0.001). Cases had a markedly higher incidence of familial asthma history (86.1% vs. 0.0%, p < 0.001), atopy (95.8% vs. 0.0%, p < 0.001), food allergies (80.6% vs. 9.5%, p < 0.001), and animal contact (79.2% vs. 14.3%, p < 0.001) compared to controls. The genetic marker rs4795399's CC allele was found in 10.0% of controls but not in any cases (p = 0.024), and the AA allele of rs7927044 was significantly more common in controlled asthmatics than in uncontrolled ones (p = 0.030). Conclusion: The studied genetic variants were not significantly associated with asthma severity; however, patients with uncontrolled asthma were associated with significantly higher polymorphism of GG and AG alleles of rs7927044. Additionally, there was a significant difference between the asthmatic patients and healthy individuals in terms of the polymorphism of the rs4795399 TT allele. [ABSTRACT FROM AUTHOR]

Egyptian women's religious expressions in papyrus letters (Bagnall and Cribiore, 2006) were divided into five categories: None , no god(s) mentioned; Pray , containing "Pray" without gods; Gods , for Greek Gods; Sarapis/local Gods/ προσκυνήµα for letters containing prayers in which obeisance before a God is expressed in the Egyptian reverential manner, a προσκυνήµα ; Θεός / Κύριος / Χριστός letters to the Christian God. The None category is prevalent during the early 300 BC to 100 AD period followed by an increase in, and then stable, formulaic/religious expressions. The Pray category peaked in the second and third centuries AD, and the Gods category, referring to pagan Gods, showed a steady and significant decline from the first to the fourth century AD inverse to the rise in prevalence of letters in the Θεός / Κύριος / Χριστός category. The shift to monotheism with Christianity is rendered in graphic form, and permits an appreciation of feminine popular sentiment on religion and its Gods in Egypt. [ABSTRACT FROM AUTHOR]

About ten per cent of Egyptian students are registered in 27 private universities and four private community universities in Egypt, amounting to 300,000 students studying in 169 faculties. Based on resident field experiences and drawing on communications with senior university managers in two private universities spanning six years, this research argues that a number of challenges persist in the implementation of transnational education in Egypt. Through the prisms of rational choice theory and institutional theory, it is found that underfunding, political interference (including ‘pedagogical balancing’) and negative norms set by university owners, managers and students alike, compounded by macro-economic instability, have had a major impact on the student experience and wider society. The findings are to various degrees applicable to other states in the Middle East, Africa and the wider Global South, as well as primary foreign stakeholders, such as the United Kingdom in this case. [ABSTRACT FROM AUTHOR]

This paper investigates how the Hyksos' notoriety was forged in seventeen ancient textual sources, considering the origins of the vilification of the Hyksos, the development of the vocabulary associated with these foreign rulers, and how the Thebans or Egyptians perceived themselves in direct contrast with the Hyksos. The study reveals that the negative terminology used in the textual sources to refer to the Hyksos is gradual and suggests that the growing hostility between Upper and Lower Egypt resulted in a shift in discourse to justify the conflict between the two kingdoms together with the establishment of a warrior ethos. Ultimately, this research highlights the pivotal role of the Theban (Egyptian) sources in shaping the legacy of the Hyksos that became a key "cultural memory" to articulate and affirm ancient Egyptian cultural identity in the New Kingdom. [ABSTRACT FROM AUTHOR]

Background: In Egypt, salted fish is considered a typically processed fish, including salted sardine, salted mullet (feseikh), keeled mullet (sahlia), and herrings. High-quality protein, polyunsaturated fatty acids, vital amino acids, and trace minerals such as magnesium and calcium are all abundant in fish. However, eating salted fish can expose people to toxins found in the environment, such as heavy metals. Aim: In Zagazig, Egypt, four types of locally produced salted fish--salted sardine, feseikh, sahlia, and herrings--were tested for heavy metals, specifically lead (Pb), cadmium (Cd), arsenic (As), and mercury (Hg). Second, the assessed heavy metals linked to the Egyptian population's consumption of salted fish were used to calculate estimated daily intakes (EDIs) and potential health hazards, such as hazard quotient (HQ) and hazard index (HI). Methods: Samples of salted herrings, feseikh, sahlia, and sardines were gathered from the markets in Zagazig. Samples of salted fish were subjected to acid digestion and then heavy metal extraction. Atomic absorption spectrometers (AAS) were used to measure heavy metals. HI, HQ, and EDI were computed computationally. Results: With the exception of mercury, which was not found in the salted herrings, the recorded results showed that all of the tested metals were present in the samples that were evaluated. The herrings contained residual Pb and Cd contents that were highest, followed by sardine, feseikh, and sahlia, in that order. After sardine, herrings, and sahlia, feseikh has the greatest concentration. Sardine, feseikh, and sahlia had the highest quantities of mercury, in that order. A number of samples were found to be above the maximum allowable levels. There were no apparent hazards associated with consuming such conventional fish products, according to the computed HQ and HI values for the heavy metals under investigation based on the daily intakes. Conclusion: Samples of salted fish sold in Zagazig, Egypt, had high quantities of the hazardous elements Pb, Cd, As, and Hg. Due to the bioaccumulation and biomagnification characteristics of these studied metals, such data should be taken carefully even though the computed health hazards revealed no potential problems. [ABSTRACT FROM AUTHOR]

Aim: We aimed to explore the predictors associated with obesity among adult ever-married Egyptian women aged 20–49 years based on the Egyptian Demographic and Health Survey (EDHS). Method: We included adult ever married women from the EDHS conducted in 2014 that initially recruited 21,903 women. Univariate and multivariable analysis was conducted to identify socio-demographic predictors of women's obesity. Result: We included 12,975 Egyptian women. Among them, 76% of the total respondents were obese where as 24% were with normal body mass index (BMI). In multivariable analysis, the results revealed that increasing age, higher wealth index, listening to radio at least once a week and women with primary and secondary education were at significant odds of developing obesity (p < 0.05). However, we found no association between residence of participants and the frequency of watching television upon the development of obesity (p > 0.05). Conclusion: Appropriate and targeted interventions should be implemented among the Egyptian reproductive age women to reduce the obesity as well as non-communicable diseases load associated with obesity. National Health Service policy makers should take multilevel approach targeting high risk sub-groups to raise awareness and to provide prevention against obesity and the subsequent complications. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has an important component of organ damage which is COVID-19-associated coagulopathy. It is necessary to assess the risk in patients to develop a thrombophylaxis plan. The higher prevalence of key thrombophilic genetic variants, such as mutation of the C677T-methylenetetrahydrofolate reductase (MTHFR) gene in Eastern Mediterranean countries, makes it challenging to use the same criteria in other world countries with differing thrombophilic panels. Objective: To find the incidence of MTHFR gene polymorphism in a cohort of Egyptian patients with COVID-19, and its association with thromboembolic events. Subjects and methods: This was a prospective observational cohort study, done at Ain-Shams University isolation Hospitals, Cairo, Egypt. It included 33 patients with COVID-19 and 13 healthy controls. The patients underwent lab investigations: HRCT chest in which the extent of radiological affection was described in terms of severe form (> 50% of lungs are affected) and non-severe form (< 50% of lungs are affected) and assessment of MTHFR-C677T genotypes. Then follow-up for 28 days for vascular thrombotic manifestations. Results: Out of 33 patients, MTHFR-gene mutation was found in 10 (incidence rate 30.3%). Severe form of affection in the HRCT chest was significantly related to mutation of the MTHFR gene (P value = 0.009). Patient cure and discharge were significantly related to the absence of mutation of MTHFR-gene (P value = 0.025), whereas death and radiological evidence of thrombosis were significantly related to the presence of MTHFR-gene mutation (P value = 0.027 and 0.022 respectively). Age > 55 years (60% sensitivity, 100% specificity, PPV 100%), albumin ≤ 3.2 gm/dl (50% sensitivity, 95.65% specificity, PPV83.3%), and ferritin > 453 ng/L (70% sensitivity, 82.61% specificity, PPV 63.6%) were predictors of mutation of MTHFR-gene. Conclusion: Incidence of mutation of MTHFR-gene was 30.3% in COVID-19 patients. Results suggest a potential association between inherited MTHFR gene mutation and severe form of COVID-19, thromboembolic events, and mortality. Trial registration: ClinicalTrials.gov ID: NCT05679414. https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000CU2V&selectaction=Edit&uid=U00056R5&ts=2&cx=lrrb7q. Retrospectively registered. 9th Jan 2023. [ABSTRACT FROM AUTHOR]

Background and study aims: Peroral endoscopic myotomy (POEM) has been regarded as a novel and minimally invasive therapy for the treatment of achalasia. Data from the Middle East and North Africa (MENA) region and Arabic countries are scarce, and this study represents the first study from this area. The aim of this study was to assess the efficacy and safety of POEM in an Egyptian cohort. Patients and methods: This is a prospective study that included 34 Egyptian patients who underwent POEM for achalasia. Results: This study included 19 (55.9%) males with a median age of 33.5 years (range: 11–75 years). 16 (47.1%) patients had previous pneumatic balloon dilation, and 1 (2.9%) patient had previous surgical myotomy. The median Eckardt score pre-POEM was 9 (range: 4–12). The median integrated relaxation pressure for 4 s (IRP4s) was 25.6 mmHg (range: 11.5–49.4 mmHg). High-resolution manometry showed that 12 patients had type I achalasia (35.2%), 18 patients had type II achalasia (52.9%), and 4 patients had type III achalasia (11.7%). The median procedure time was 120 min (range: 75–260 min). Technical success was achieved in all patients (100%), and clinical success was achieved in 33/34 patients (97.1%). There was no significant difference in success rates among different types of achalasia (p 0.208). There was a significant reduction in the Eckardt score (P < 0.0001) and IRP4s values pre- and post-POEM (P < 0.0001). There was also a significant increase in the body mass index of the patients (P 0.006) during a median follow-up of 10 months (range: 6–24 months). Conclusions: POEM is a safe, effective, and feasible treatment option for achalasia in an Egyptian cohort. POEM is becoming an attractive option and is gaining patient satisfaction. [ABSTRACT FROM AUTHOR]

Background: The Achenbach System of Empirically Based Assessment (ASEBA) forms are among the most studied instruments for assessing behavioral, emotional, social, and thought problems in children and adolescents worldwide. Although ASEBA instruments have been translated into Arabic, fewer studies have investigated their psychometric properties and norms in Arabic speaking societies than in other societies. Methods: Revisions were made to the Modern Standard Arabic (MSA) translations of the Child Behavior Checklist for Ages 6–18 (CBCL/6–18), the Teacher's Report Form (TRF), and the Youth Self-Report (YSR). Parents of 6–18-year-olds who came to the general pediatric clinic in Tanta University Hospital during a 2-year period for routine check-ups were invited to fill out the CBCL/6–18 (N = 595), while 11–18-year-olds were invited to fill out the YSR (N = 409). TRFs were filled out by teachers (N = 329). Results: Confirmatory factor analyses supported the previously reported eight-factor syndrome structure of the forms with good psychometric properties and moderate cross-informant correlations. The mean CBCL/6–18 and YSR Total Problem scores qualified for the previously established ASEBA Multicultural Norm Group 2, while the mean TRF Total Problem score qualified for group 3. Conclusions: The good psychometric properties and the identification of Multicultural Norm Groups for scores obtained with the Arabic translations of ASEBA forms in Egyptian society support use of the ASEBA for assessment and outcome evaluations of behavioral, emotional, social, and thought problems among Egyptian youth. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the adherence pattern to medications and the influence of non-adherence on hospitalization rate among Egyptian patients who were diagnosed with systemic lupus erythematosus (SLE). Methods: This cross-sectional interview-based study was conducted in an Egyptian rheumatology outpatient clinic. Individuals with SLE who were prescribed oral medications were included in the study. The 19-item Compliance Questionnaire of Rheumatology (CQR) was employed to evaluate drug adherence. Patients were classified as non-adherent and adherent group based on their CQR score Sociodemographic variables, clinical and therapeutic data, and the frequency of outpatient visits and hospitalization were collected and compared between the two groups. Results: In total, there were 161 SLE patients who participated in the study with mean age 30.70 ± 9.62 years, 129 females and 32 males (F:M 5.4:1). Of them, 93 patients were assigned to the non-adherent group, whereas 68 patients were assigned to the adherent group. There was a statistically significant difference in terms of marital status (p = 0.009), employment (p = 0.032), and the frequency of physical activity (p = 0.045) between the two groups. The adherents had a higher rate of administration of antimalarials (88.2% vs 75.3%, p = 0.039). The frequency of recurrent fever was lower in adherents (23.5% vs 38.7%, p = 0.042), lymphadenopathy (11.8% vs 31.2%, p = 0.004), recurring oral ulcers (25% vs 50.5%, p = 0.001), and substantial hair loss (87.1% vs 98.5%, p = 0.009) in comparison to non-adherents. The number of yearly outpatient visits was considerably greater in adherents (p = 0.007), while the number of prior hospitalizations was higher in non-adherents (p < 0.001). Non-adherents believed that taking medicines disrupt patients' daily routine (p < 0.001) and were more afraid of the occurrence of an adverse drug reaction (p < 0.001). Conclusions: Egyptian SLE patients have an alarmingly high percentage of medication non-adherence. There is a strong association between medication non-adherence and frequency of hospitalization and cumulative clinical manifestations. [ABSTRACT FROM AUTHOR]

Background There is mounting evidence that the genotypes of DNA repair proteins and susceptibility to certain malignancies are related. Few studies, however, have examined the role of the homologous repair gene X-ray repair cross-complementing group 3 (XRCC3) genotype and xeroderma pigmentosum complementation group D (XPD) in the development or prognosis of acute lymphoblastic leukaemia (ALL). Aim of the study In this study, we investigated the impact of XRCC3 rs861539 and XPD rs13181 polymorphisms on the risk of ALL. To the best of our knowledge, this is the first report of XRCC3 and XPD polymorphisms in ALL Egyptian patients. Methods Polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) was used to analyse XRCC3 rs861539 and XPD rs13181 gene polymorphisms in 96 patients with ALL and in 103 disease-free controls, who were of a similar age. Results ALL risk is lower in individuals with the homozygous variant TT genotype at XRCC3 rs861539. The heterozygous variant CT genotype of XRCC3 was connected to increased disease risk of ALL in males. Additionally, C allele frequency was noticeably higher than T allele frequency in pre B ALL. In this investigation, there was no correlation between the XPD Lys751 rs13181 polymorphism and risk of ALL. Conclusion Our research reveals that genetic variation in the genes for DNA repair may influence ALL susceptibility. [ABSTRACT FROM AUTHOR]

Introduction: Atorvastatin is regarded as the most frequently prescribed statin worldwide for dyslipidemia. However, clinical response and risk of adverse effects to statin therapy are associated with genetic variations. Numerous research linked statins pharmacokinetics (PK) variations to genetic polymorphisms in cytochromes P450 (CYPs) metabolic enzymes. Objective: This article reviews the association between CYP3A4/5 genetic variations and response to atorvastatin therapy globally, which includes atorvastatin PK, and the risk for adverse reactions, with a hint to the Egyptians. Methods: Up to March 30, 2022, electronic medical databases like PubMed, Web of Science, MEDLINE, and Egyptian Knowledge Bank (EKB) were searched. All articles that highlighted the relationship between CYP3A4/5 genetic polymorphisms and atorvastatin efficacy/safety profile were included in this review. Results: Initially, 492 articles were retrieved after an exhaustive search. There were 24 articles included according to the inclusion criteria. Findings of association studies of CYP3A4/5 genetic polymorphisms with response to atorvastatin varied among different ethnicities. CYP3A4*1B was associated with better therapeutic outcomes after atorvastatin therapy in Chileans and vice versa in Americans. Caucasians with myalgia while using atorvastatin were at significant risk of suffering severe muscle damage if they were carriers of CYP3A5*3/*3. As far as we can report for the Egyptian population, the impact of CYP3A4/5 genetic variations on the response to atorvastatin therapy was understudied. Conclusion: More pharmacogenetic studies amongst diverse populations worldwide, like the Egyptian population, are necessary to detect further atorvastatin-gene interactions. Keypoints: CYP3A4/CYP3A5 genetic polymorphisms could influence the efficacy and safety of atorvastatin. Numerous research results linking CYP3A4/5 genetic polymorphisms to atorvastatin response varied by ethnicity. CYP3A4/5 genetic polymorphisms' role in atorvastatin response in the Egyptian population has received little attention. [ABSTRACT FROM AUTHOR]

This paper is positioned within broader scholarly debates about ritual‐religious and psychological elements underlying the phenomenon of altered states of mind in Egyptian Muslim contexts. This research examines the intricate relationships between ritual, consciousness, and the unseen/unknowable world reflected in the imagination and practices of urban and rural communities belonging administratively to the city of Tanta in Egypt. This comparative study proposes that the image of the embodied invisible Other, in both benevolent and malevolent forms, impacts the state of consciousness of persons participating in two different rituals, the zikr (remembrance of God) and the zār (the exorcism of spirits). This inquiry concentrates on the transformation of the states of people's consciousness, namely the majzūb (those mystically attracted to God) and the malbūs (those possessed by spirits), through embodied engagement with the invisible Other that is made visible through participation in the ritual performances of the zikr and/or the zār. Rituals performed by Egyptians, particularly those who experience altered states of consciousness, display both a psychic (emotional) experience and an encounter with the invisible Other that may be depicted as divine or otherwise non‐divine. Each case of the zikr ritual and zār cult relates to its participants' perception of reality. [ABSTRACT FROM AUTHOR]

Background: Refugee healthcare workers (HCWs) can make important contributions in host countries, particularly in the wake of the ongoing COVID-19 pandemic, which has exacerbated existing shortages of frontline HCWs. However, refugee HCWs often face challenges entering the labour markets of such countries even where needs exist. Syria's decade-long conflict has forced thousands of HCWs from their homes; however, data on this population are limited, impeding the formation of policies that can support them. This study explores the experiences of Syrian refugee HCWs in Egypt. Methods: Key informants (KIs) were selected using purposive and snowball sampling method and semi-structured interviews were conducted in person in Cairo and remotely from the UK during July 2019. Interviews were conducted in Arabic and analysed using a combined deductive and inductive thematic analysis framework after transcription into English. Results: Fifteen KI interviews were analysed. The main emerging themes from the qualitative interviews are those relating to 1. Education, training, and licensing 2. Politics and bureaucracy 3. Societal factors 4. Economic factors. Political changes in Egypt altered opportunities for Syrian HCWs over time; however, refugee HCWs broadly reported acceptance among Egyptian patients and colleagues. Bureaucratic factors which impede the ability of Syrian refugee HCWs to obtain a full license to practice and leave to remain and the absence of clearly defined policies were reported as barriers. Economic factors including the risk of economic exploitation e.g. in the informal sector and financial insecurity were noted to have a negative psychosocial impact. Conclusions: This is the first qualitative research study which explores the experiences of Syrian refugee HCWs in Egypt. It adds to the sparse literature on the topic of Syrian refugee HCWs but provides evidence for further discussions on how to support refugee HCWs in Egypt and in other host countries in the region. Though interviews were conducted before the COVID-19 pandemic, the pandemic itself lends urgency to the discussion around refugee HCWs on an international level. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to evaluate soft-tissue changes in Egyptian cleft lip/palate (CLP) patients after conservative non-surgical maxillary advancement using face mask therapy. Methods: This prospective cohort study included 20 Egyptian patients with unilateral CLP, six females and 14 males, ranging in age from 10 to 15 years and suffering from moderate maxillary deficiency. These patients had been chosen randomly from the Oro-dental Genetics Clinic at the National Research Centre, Egypt. For lateral cephalometry tracing and superimposition of pre-operative and post-treatment data, this study used Dolphin 11.0 software. Subnasal (Sn), pronasal (Pn), soft tissue pogonion (Pg), labial superior (Ls), stomion superioris (Ss), labiale inferior (Li), stomion inferioris (Si) and soft tissue Menton (Me) were the soft tissue points used in this analysis. Results: All of the cases were successful and demonstrated a positive response to the orthodontic traction. All post-operative linear measurements of the measured soft-tissue points showed statistically significant advancement (P = 0.05) except for pronasal linear measurements, which did not show a significant difference post-treatment (P = 0.84). Discussion: With the use of the face mask procedure, both upper and lower lip soft-tissue points improved significantly, but nasal points remained unchanged, requiring more management. [ABSTRACT FROM AUTHOR]

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Meat products represent an important source of animal-derived protein. However, meat products are also implicated as a potential source of human exposure to some chemical residues such as aflatoxins (AFTs). The objectives of the present study were first to estimate the total AFTs content in the retailed meat products (beef luncheon, sausage, and pasterma) in Sharkia governorate, Egypt. Besides, dietary intake and potential health risks for the Egyptian population associated with the consumption of AFTs-contaminated meat products were further calculated. The obtained results revealed that pasterma had significantly the highest AFTs content, followed by luncheon, and sausage respectively. Calculation of the daily intakes of the total AFTs revealed that consumption of bovine meat products represents a potential source for dietary exposure to total AFTs. However, the calculation of the margin of exposure of total AFTs among the Egyptian population based on the average consumption of meat products revealed that such meat products might not possess a cancer risk among Egyptian adults and children. In general, excessive consumption of such meat products should be avoided for long-life protection against AFTs-related cancer risk. [ABSTRACT FROM AUTHOR]

Background: COVID-19 booster dose vaccination acceptance and actual vaccination behavior is not known among Egyptian individuals with autoimmune and rheumatic diseases (ARDs). The aim of this study was to investigate the acceptability of booster dose of the COVID-19 vaccine, as well as the factors that drive and inhibit that acceptance among Egyptian patients diagnosed with ARDs. Methods: This interview-based, cross-sectional analytical study was carried out on ARD patients from 20 July to 20 November 2022. A questionnaire was created to assess sociodemographic and clinical data, as well as COVID-19 vaccination status and the intention to receive a COVID-19 vaccine booster dose, perception of health benefits of it in addition to the perceived barriers and/or concerns. Results: A total of 248 ARD patients were included, with a mean age of 39.8 years (SD = 13.2), and 92.3% were females. Among them, 53.6% were resistant to the COVID-19 booster dose, whereas 31.9% were acceptant and 14.5% were hesitant. Those who were administering corticosteroids and hydroxychloroquine shown significantly greater booster hesitancy and resistance (p = 0.010 and 0.004, respectively). The primary motivation for taking a booster dose among the acceptant group was own volition (92%). Most acceptants believed that booster dose can prevent serious infection (98.7%) and community spread (96.2%). Among the hesitant and resistant groups, the main concerns for booster dose were fear about its major adverse effects (57.4%) and long-term impact (45.6%). Conclusions: There is a low acceptability rate of booster dose of COVID-19 vaccine among Egyptian patients with ARD diseases. Public health workers and policymakers need to make sure that all ARD patients get clear messages about accepting the COVID-19 booster dose. [ABSTRACT FROM AUTHOR]

New musical styles with streetwise lyrics were prominent during the 2011 revolution and continue to be popular with Egyptian youth, despite authorities' disapproval. [ABSTRACT FROM AUTHOR]

Wasting is one of the symptoms of malnutrition that has been connected to the deaths of malnourished children. This study was intended to explain the effect of socio‐demographic and economic factors on under‐5 wasting by evaluating their conditional effect across the distribution of weight‐for‐height Z (WHZ) scores using the quantile regression (QR) model. The weighted sample which included 13,680 children under 5 years was taken from the countrywide Egyptian DHS 2014 survey. The results depicted that about 2% of Egyptian children were severely wasted, with the prevalence of wasting being around 8%. It was discovered that across the WHZ distribution, the child's features, maternal characteristics, father's education, and social factors had significant but varied contributions in explaining the wasting status of under‐5 children. It was revealed that female children had a significant weight advantage, notably 0.21 standard deviation (SD) higher weight at the 95th quantile over their male counterparts. The WHZ score was also found to be significantly positively associated with both age and household's wealth status at the lower and upper tails of the WHZ distribution, respectively. Moreover, in comparison with children whose mothers were underweight, those whose mothers were normal or overweight had higher WHZ scores, with a 1.45 SD increase in WHZ scores at the 95th quantile for mothers who were normal weights. Furthermore, the children who were breastfed, whose mothers received antenatal care (ANC) services, and/or who had educated parents had an advantage in terms of WHZ scores than their counterparts. In addition, the children with higher birth order and/or who resided in urban areas had weight disadvantages compared to their counterparts. Therefore, in order to improve children's nutritional status and achieve the Sustainable Development Goals (SDGs) by 2030, the government and public–private owner organizations must work together at the community level focusing on vulnerable groups. [ABSTRACT FROM AUTHOR]

(1) Background: Streptococcus agalactiae or Group B Streptococcus (GBS) causes severe neonatal infections with a high burden of disease, especially in Africa. Maternal vaginal colonization and perinatal transmissions represent the common mode of acquiring the infection. Development of an effective maternal vaccine against GBS relies on molecular surveillance of the maternal GBS population to better understand the global distribution of GBS clones and serotypes. (2) Methods: Here, we present genomic data from a collection of colonizing GBS strains from Ismailia, Egypt that were sequenced and characterized within the global JUNO project. (3) Results: A large proportion of serotype VI, ST14 strains was discovered, a serotype which is rarely found in strain collections from the US and Europe and typically not included in the current vaccine formulations. (4) Conclusions: The molecular epidemiology of these strains clearly points to the African origin with the detection of several sequence types (STs) that have only been observed in Africa. Our data underline the importance of continuous molecular surveillance of the GBS population for future vaccine implementations. [ABSTRACT FROM AUTHOR]

Acute gastroenteritis (AGE) induced by rotavirus has been a major disease burden in Egypt since 1981 when rotavirus was first reported in humans and calves. Genome segmentation facilitates the emergence of new virus serotypes, which allows reassortment during mixed infections, and is a characteristic feature of the family Reoviridae to which rotavirus belongs. The rotavirus genome involves 11 double-stranded RNA gene segments encoding 6 nonstructural (NSP1-6) and 6 structural (VP1-4, VP6, VP7) proteins. Rotavirus A has a zoonotic potential associated with diarrhea. The primary strategy for prevention and control of bovine and human rotavirus infections is vaccination; however, routine rotavirus vaccination has not been implemented in the National Immunization Program. We evaluated studies published over the last 30 years that pertained to the epidemiology of circulating rotavirus genotypes among children, calves, and environmental samples in Egypt. The analysis revealed a rotavirus prevalence of 15%-100%, with diarrhea occurring throughout the year, but generally peaking during the cold months. G1 was the predominant genotype in children, followed by G2, G3, G4, G8, G9, and G12 throughout the study duration. Mixed infections were also detected. G6 was the predominant genotype in calves, followed by G10. There are still gaps in knowledge regarding molecular data of rotavirus infections in humans, animals, and environmental samples in Egypt, as well as the zoonotic potential of rotavirus disease. Therefore, it is critical to continue rotavirus surveillance in Egypt to further understand the epidemiology of rotavirus infections and the emerging new genotypes. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B virus infection (HBV) is one of the major public health problems, which in addition to physical disorders, affects patients' quality of life (QoL). In Egypt, the prevalence of HBV is 1% while 87.2% of the liver cirrhosis patients reported poor QoL. Objective(s): The present study was conducted to investigate the effect of chronic hepatitis B (CHB) on the QoL in Egypt. Methods: An observational cross-sectional study was conducted in the Clinic of "On State Expenses Treatment" in Alexandria and Cairo for 18 months using WHOQO-BREF 26 questionnaire. It is composed of four domains: physical, social, psychological, and environmental. Each domain included different facets. A total of 294 HBV patients, as well as 64 physicians, as a control, participated in the study. Representation of the different chronic hepatitis B clinical stages was ensured. Results: The overall 100-format QoL score was low (0.2). The QoL score among Hepatocellular Carcinoma (HCC) patients was the lowest, with the physical domain being greatly impaired, while the QoL score in the Chronic hepatitis B clinical stage was the highest, with the psychological domain showing the greatest impairment. Stepwise multiple regression modeling resulted in three main predictors (classification of the clinical stage, marital status, and smoking). These predictors were responsible for 41% of the variance in the QoL score. The classification of the clinical stage and smoking were inversely correlated to the QoL, the marital status was positively correlated. Conclusion: The current study highlighted the importance of social support in the management of CHB patients. Moreover, the rehabilitation programs in the late stages of the disease are highly recommended, as the physical aspects become more affected at the end stage of the disease, as well as psychological aspects. The importance of early diagnosis and management of cases is an important priority especially with the fact that the clinical stage is a major predictor of the overall QoL of the patients. [ABSTRACT FROM AUTHOR]

In the Late Bronze Age, Egypt controlled the city-states of the Southern Levant, even though local rulers maintained partial autonomy. However, the period ended with a crisis that seems to have considerably changed the local power structures along with the disappearance of the Egyptian empire in the region. This paper shows how both Egyptian power and its relatively rapid disappearance worsened the crisis. Three factors are highlighted: Egyptian policy of weakening the defensive capabilities of Levantine city-states, the Egyptians' demand for different resources and how these two aspects made city-states unable to adapt successfully to the new post- Egyptian situation. [ABSTRACT FROM AUTHOR]

Blastocystis sp. is a widespread enteric protozoan that frequently infects human and animal groups. Despite its burden and zoonotic potential worldwide, epidemiological investigations remain limited in animal groups that come in contact with humans. Therefore, the largest survey ever conducted in North Africa was performed in Egypt with the aim to investigate the prevalence and subtype (ST) distribution of Blastocystis sp. in animals. For this purpose, a total of 889 fecal specimens were collected from chickens (217), cattle (373), dogs (144) and cats (155) from six governorates of northern Egypt. These specimens were then screened for the presence of Blastocystis sp. using a quantitative real-time PCR, followed by subtyping the isolates. The overall prevalence of Blastocystis sp. reached 9.2% (82/889), with the highest infection rates reported in chickens (17.0%) and domestic cattle (11.0%), highlighting an active circulation of the parasite in both animal groups. In contrast, the low prevalence in cats (2.6%) and the absence of the parasite in dogs suggested that pets are not natural hosts of Blastocystis sp. ST10 and ST14 were largely predominant in cattle, confirming that both STs represented cattle-adapted STs. The report of one ST3 and one ST4 isolate in this animal group could be explained by an accidental zoonosis from humans to animals. All but one of the subtyped isolates in poultry belonged to ST7, which was considered as an avian ST. The presence of a remaining isolate of ST14 likely reflected a transient infection from contact between birds and cattle feces. The same environmental contamination was also likely the source of the ST14 infection in three of the four positive cats, with the remaining animals infected by ST3 as the result of human-to-animal transmission. These occurrences and subtyping data, combined with those previously collected in the Egyptian population, implies that poultry could play a significant role as reservoir for zoonotic transmission, which would not be the case for cattle and pets. [ABSTRACT FROM AUTHOR]

Systemic lupus erythematosus (SLE) susceptibility has a strong genetic component. Genome-wide association studies (GWAS) across transancestral populations show both common and distinct genetic variants of susceptibility across European and Asian ancestries, while many other ethnic populations remain underexplored. We conducted the first SLE GWAS on Egyptians-an admixed North African/Middle Eastern population-using 537 patients and 883 controls. To identify novel susceptibility loci and replicate previously known loci, we performed imputation-based association analysis with 6,382,276 SNPs while accounting for individual admixture. We validated the association analysis using adaptive permutation tests (n = 109). We identified a novel genome-wide significant locus near IRS1/miR-5702 (Pcorrected = 1.98 × 10-8) and eight novel suggestive loci (Pcorrected < 1.0 × 10-5). We also replicated (Pperm < 0.01) 97 previously known loci with at least one associated nearby SNP, with ITGAM, DEF6-PPARD and IRF5 the top three replicated loci. SNPs correlated (r2 > 0.8) with lead SNPs from four suggestive loci (ARMC9, DIAPH3, IFLDT1, and ENTPD3) were associated with differential gene expression (3.5 × 10-95 < p < 1.0 × 10-2) across diverse tissues. These loci are involved in cellular proliferation and invasion--pathways prominent in lupus and nephritis. Our study highlights the utility of GWAS in an admixed Egyptian population for delineating new genetic associations and for understanding SLE pathogenesis. [ABSTRACT FROM AUTHOR]

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Simple Summary: Group A rotaviruses are the most common cause of acute gastroenteritis affecting Egyptian children under the age of five, with symptoms ranging from asymptomatic infection to severe dehydration or death. In the present work, diarrheal samples from Egyptian children admitted to gastrointestinal pediatric wards of two main governmental hospitals were collected and molecularly analyzed for Group A rotavirus. Our findings revealed that rotaviruses accounted for more than one-sixth of all cases under study, peaking in the winter. G1P[8] was the most prevalent rotavirus genotype in this study. The two cell lines used in our work coherently isolated and propagated rotavirus strains. Continuous rotavirus detection and genome sequencing of the successfully isolated strains will be recommended in the future in order to support the control of such viruses, and tackle the problem in Egypt. The most prevalent cause of infectious neonatal diarrhea is Group A rotavirus (RVA). Unfortunately, there is a dearth of data on the incidence of rotavirus-associated infections among Egyptian children. The present study aimed to isolate, propagate, and genotype human rotaviruses circulating among Egyptian children with acute gastroenteritis admitted to two main university pediatric hospitals, Abo El-Reesh and El-Demerdash, over two consecutive winters, 2018–2020. Diarrheal samples (n = 230) were screened for Group A rotavirus RNA using RT-PCR assay. In positive samples (n = 34), multiplex semi-nested PCR was utilized to determine G and P genotypes. Thirty-four (14.8%) of the collected samples tested positive. The genotype distribution revealed that G1P[8] was the predominant rotavirus genotype throughout the current study. All rotavirus-positive fecal samples were passaged twice on human colorectal adenocarcinoma cell line (Caco-2) and rhesus monkey kidney epithelial cell line (MA104). Both cell lines could successfully isolate 14.7% (n = 5 out of 34) of the identified strains; however, Caco-2 cell line was shown to be more efficient than MA104 in promoting the propagation of human rotaviruses identified in Egyptian children's feces. [ABSTRACT FROM AUTHOR]