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In this article, we investigate the links between medical practice and expertise, on the one hand, and nationalist discourses, on the other, in the 2011 Egyptian uprising and the years that followed, which witnessed a consolidation of authoritarianism. We ask how it is that doctors, whose social capital in part rests on their being seen as "apolitical," played a significant role in countering consecutive regimes' acts of violence and denial. We trace the trajectory of the doctors' mobilization in the 2011 uprising and beyond and demonstrate how the doctors drew on their professional expertise and nationalist sentiment in their struggles against a hypernationalistic military state. Borrowing the ideas of immanence and transcendence from religious studies and philosophy, we argue that the doctors put forth an immanent vision of the nation as a force that is manifested in the lives of its citizens, in contrast with the State's transcendent vision of nationalism, in which the nation resides outside of and beyond citizens' lives. Relying on interviews and media analysis, we show how medicine has served as a site of awakening, conversion narratives, and building of bridges in a polarized society where the doctors were able to rely on their "neutral" expertise to present themselves as reliable witnesses, narrators, and actors., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

In this article, we discuss the inextricable entanglement of public health and political revolution, and why comics is a particularly amenable medium to explore how different people come to terms with illness and mortality against the backdrop of political, economic, and environmental crises. We discuss our process in creating a sequential comic narrative, Lissa, that portrays a working-class Egyptian family, informed by hundreds of interviews and ethnographic research in Egypt on the vulnerabilities that expose people to kidney and liver disease and the difficulties of accessing proper treatment. Lissa also draws on ethnographic research and interviews in the U.S. on a seemingly unrelated topic - the social and political calculus of managing genetic risk for breast and ovarian cancer within a commercial healthcare system. We draw out the similarities in bioethical dilemmas between these two disparate clinical realities by composing an unlikely friendship between two fictional characters: Anna, the daughter of an American oil company executive living in Cairo, who has a family history of breast cancer - and Layla, the daughter of the porter of Anna's apartment building, who grows to become a resolute physician struggling for better public health justice and rights in Egypt.

Objective: This study aimed to report the severity of COVID-19 in a cohort of Egyptian patients with multiple sclerosis (MS) with particular attention on the impact of disease modifying drugs (DMDs)., Methods and Study Population: We included 119 MS patients recruited from two centers, Ain-Shams university and Cairo university with confirmed or suspected COVID-19 during the period from May to September 2020 as a part of the MuSC-19 project. Univariate logistic regression was fitted to assess risk factors for severe COVID-19 (at least one outcome among hospitalization, ICU admission and death)., Results: Females were 77%, mean age was 34 years, mean duration of MS was 5.28 years, median EDSS was 3, most of the patients (83%) had RRMS, while 15% and 2% had respectively SPMS and PPMS. Only eleven patients (9% of study population) had a severe outcome and 3 patients (3%) died. Headache was the only symptom significantly associated with the severity of COVID-19 (OR=10.85, P = 0.001). There was no association between any of the DMDs and severe COVID-19 outcome., Conclusion: This study showed an acceptable safety profile of DMDs in Egyptian MS patients who developed COVID-19, as 91% of the cohort had a favorable outcome. Headache as a symptom associated with severe outcome in Egyptian patients' needs further validation., (Copyright © 2021. Published by Elsevier B.V.)

Several host and viral factors affect the natural history of Hepatitis C Virus (HCV) infection. Interleukin 28B (IL28B).rs12979860 single nucleotide polymorphism (SNP) was found to predict viral clearance with and without therapy. Subjects with the CC (favorable) genotype of IL28B.rs12979860 were more likely to spontaneously clear the infection and respond favorably to therapy. These data suggest that subjects with the "favorable" CC genotype might have a lower viral load when compared to those with the "unfavorable" TT genotype. Therefore, we examined the effect of IL28B.rs12979860 SNP on HCV viral load and clearance among HCV-infected Egyptians. This cross sectional study was conducted on 375 HCV antibody-positive subjects. Detection and quantification of HCV-RNA was determined by RT-PCR. IL28B.rs12979860 genotyping was performed using SYBR green real-time PCR and specific primers. Of 375 HCV-antibody positive subjects, 239 (63.7%) had chronic HCV infection while the remaining 136 (36.3%) subjects had spontaneously cleared the virus. The frequency of IL28-B CC, CT, and TT genotypes among spontaneous resolvers were 54.4%, 39.0%, and 6.6% while among the chronically infected subjects, they were 31.4%, 49.8%, and 18.8%, respectively. As expected, IL28 genotype predicted spontaneous HCV clearance (p < 0.001). The average HCV viral loads were 1.5 ± 0.69 x 10(6), 0.62 ± 0.11 x 10(6) and 0.51 ± 0.14 x 10(6) IU/ml among chronic subjects with the IL28B.rs12979860 CC, CT and TT genotypes, respectively (p > 0.05). In conclusion, our results show that IL28B.rs12979860 genotype does not affect viral load among chronic HCV infected Egyptians. These findings further confirm the complexity of viral host interactions in determining HCV infection outcome.

Background/aims: Variceal bleeding is one of the most frequent causes of morbidity and mortality among cirrhotic patients. Clinical endoscopic features and outcomes of cirrhotic patients with non-variceal upper gastrointestinal bleeding (NVUGIB) have been rarely reported. Our aim is to identify treatment outcomes and predictors of in-hospital mortality among cirrhotic patients with non-variceal bleeding in Upper Egypt., Materials and Methods: A prospective study of 93 cirrhotic patients with NVUGIB who were admitted to the Tropical Medicine and Gastroenterology Department, Assiut University Hospital (Assiut, Egypt) over a one-year period (November 2011 to October 2012). Clinical features, endoscopic findings, clinical outcomes, and in-hospital mortality rates were studied. Patient mortality during hospital stay was reported. Many independent risk factors of mortality were evaluated by means of univariate and multiple logistic regression analyses., Results: Of 93 patients, 65.6% were male with a mean age of 53.3 years. The most frequent cause of bleeding was duodenal ulceration (26.9%). Endoscopic treatment was needed in 45.2% of patients, rebleeding occurred in 4.3%, and the in-hospital mortality was 14%. Hypovolemic shock was the most common cause of death (46.2%). Independent risk factors of in-hospital mortality among cirrhotic patients with NVUGIB in our study were bacterial infection during hospitalization [odds ratio (OR) =0.32, 95% confidence interval (CI) =0.03-0.89], shock (OR =1.12, 95% CI =0.68-1.54), early rebleeding (OR =2.26, 95% CI =1.85-3.21), low serum albumin (OR =3.81, 95% CI =2.35-4.67), low baseline hemoglobin (OR =0.714, 95% CI =0.32-1.24), and the need for endoscopic treatment (OR =2.96, 95% CI =0.62-3.63)., Conclusion: Bacterial infection during hospitalization, shock, early rebleeding, low serum albumin, low baseline hemoglobin, and the need for endoscopic treatment were independent risk factors of in-hospital mortality among cirrhotic patients with NVUGIB in Upper Egypt.

Background: The response to antiviral therapy in HCV infected patients depends on several predictive factors; however, the ability to achieve sustained virological response is still limited to around 60% of the patients infected with the HCV-4 genotype. Increased serum and intrahepatic interferon -γ inducible protein 10 (IP-10) levels in patients with chronic hepatitis C have been described. The aim of the work was to study the impact of pretreatment serum IP-10 level on the antiviral treatment outcome in a group of Egyptian patients infected with HCV., Materials and Methods: The study included 80 treatment naive HCV patients. Serum IP-10 levels were determined by an enzyme linked immunosorbent assay before therapy was introduced. Serum samples were examined twice by Real-Time PCR after complete course of therapy for detection of HCV RNA; at the end of the antiviral therapy and six months later to detect sustained virological response (SVR)., Results: 57 patients (71%) achieved SVR while 23 (29%) patients were non-responders (NR). Pretreatment serum IP-10 levels were significantly lower in patients who achieved SVR than in NR (p=0.000)., Conclusion: Low pretreatment serum IP-10 is a favorable predictive of response to antiviral HCV therapy in Egyptian patients.

Drawing on two years of ethnographic fieldwork in Egypt focused on organ transplantation, this paper examines the ways in which the "scientific" criteria of determining death in terms of brain function are contested by Egyptian doctors. Whereas in North American medical practice, the death of the "person" is associated with the cessation of brain function, in Egypt, any sign of biological life is evidence of the persistence, even if fleeting, of the soul. I argue that this difference does not exemplify an irresolvable culture clash but points to an unsettling aspect of cadaveric organ procurement that has emerged wherever organ transplantation is practiced. Further, I argue that a misdiagnosis of the problem, as one about "religious extremism" or a "civilizational clash," has obfuscated unresolved concerns about fairness, access, and justice within Egyptian medical spheres. This misdiagnosis has led to the suspension of a cadaveric procurement program for over 30 years, despite Egypt's pioneering efforts in kidney transplantation.

Background: Symmetric polyarthritis associated with hepatitis C virus (HCV) infection frequently displays a clinical picture like rheumatoid arthritis (RA). Antibodies to cyclic citrullinated peptide (CCP) have high specificity for the diagnosis of RA. This study examined the frequency and clinical significance of anti-CCP antibodies in patients with chronic HCV infection, with and without manifestations of joint involvement, compared to RA patients., Methods: Serum anti-CCP antibodies and rheumatoid factor (RF) were evaluated in 30 patients with RA and 47 patients with chronic HCV infection. Of those with HCV infection, 20 patients had chronic HCV infection associated with articular involvement and 27 patients had chronic HCV infection without any articular involvement., Results: Anti-CCP antibody level was positive in 70% of RA patients, 8.5% of HCV-infected patients, and in 20% of HCV patients with articular manifestations. RF was positive in 76% of RA patients and in 60% of HCV patients with articular involvement. Cryoglobulins were found in 29% of HCV-infected patients and in 16% of RA patients. Cryoglobulins were more frequent among HCV patients with articular affection (35%) compared to HCV patients without articular affection (26%)., Conclusions: Although anti-CCP antibodies remain a useful diagnostic tool for RA, their interpretation in HCV-infected patients with arthritis should be applied with caution. The possibility that those patients could be prone to develop RA cannot be ruled out. Those patients need careful clinical and radiological follow-up. Further large-scale studies are warranted.

Two Alexandria lines selected for a high (HL) or low (LL) eight-week body weight, and an unselected Fayoumi line were used to study the duration of fertility, fertility percentage, fertility percentage duration, age at sexual maturity, egg number in the first ninety days of laying, egg weight, eight-week body weight, and body weight at sexual maturity. The fertility could be improved through selection for duration of fertility. Within the lines, early mature pullets had a longer duration of fertility than those matured later. The duration of fertility within the lines is a rather good indicator of eight-week body weight. Within the lines, the duration of fertility increases with the increase in body weight at the age of sexual maturity.

Two Alexandria lines selected for high (HL) and low (LL) body weight and one unselected Fayoumi line were compared for the duration of fertility in both sexes. In the parents, LL had a significantly higher duration of fertility than HL and Fayoumi. In the female progeny, the mean duration of fertility in HL, LL, and Fayoumi were 9.76, 11.20, and 10.66 days, respectively, and the difference among them were highly significant. Based on the sire-plus-dam components of variance, the heritability estimates of the duration of fertility were determined. Heritability estimates obtained by regressed offspring mean on dam estimate were 0.44 in HL, 0.14 in LL, and 0.93 in the Fayoumi. It can be concluded that the genetic variance of this feature - duration of fertility - was relatively high.