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Background: Vaginismus, a prevalent genito-pelvic pain/penetration disorder in the Middle East, often leads to unconsummated marriages, with a significant impact on marital and social well-being. Traditional treatments have shown limited success in refractory cases. Objective: To evaluate the effectiveness of an integrated treatment program, including Botulinum Toxin A (BTXA) injections, gradual vaginal introitus dilation, and psychological support, in treating refractory vaginismus in Egyptian women. Patients and Methods: This retrospective case series analyzed 1,400 women with refractory vaginismus, treated between January 2013 and 2023. The program comprised BTXA injections in the perineal muscles, followed by guided physiotherapy for muscle dilation and psychological counseling. Success was defined as painless vaginal penetration. Results: Of the initial 1,512 cases, 1,400 completed the program. The average age of participants was 28 years. Most patients (93%) had tried conventional treatments without success. Post-treatment, 92.6% (1,288/1,400) achieved painless penetration. The majority required 3 to 5 dilatation treatment sessions for success. Mild adverse effects were reported in 28% of cases. Conclusion: The integrated treatment program, combining BTXA injections, gradual dilation, and psychological support, is highly effective in managing refractory vaginismus in Egyptian women, with a success rate of over 90%. This approach offers a promising solution for couples facing unconsummated marriages due to vaginismus. [ABSTRACT FROM AUTHOR]

Background: Allergic rhinitis (AR) is a chronic illness, which most people are afflicted by. Objective: To evaluate the expression of interleukin-33 in patients presenting with allergic rhinitis and nasal polyposis. Patients and Methods: This study was carried out on 50 patients aged from 15 to 40 years old, both sexes, and 25 healthy volunteers matched in age and sex. Patients were allocated into two groups: Case group n= 50 and control group n= 25, then the case group was further subdivided into equal two groups: nasal polyposis group n= 25, and AR group n= 25. All patients were subjected to laboratory investigations, DNA extraction, measurement of DNA concentration, and single nucleotide polymorphism detection. Results: The most predominant genotype in sinusoidal nasal polyps was CT (60%) in both tissue and serum. Conclusions: Il 33 genotype (rs11792633) wasn't associated with allergic rhinitis and nasal polyps. [ABSTRACT FROM AUTHOR]

Background: The significance of narrative skills is evident due to their role in the development of language and their connection to significant social and academic skills. This study aimed to translate, adapt, and validate the Test of Narrative Language-Second Edition (TNL-2) for its use as a tool for the assessment of narrative language in Arabic-speaking Egyptian children. In a cross-sectional study design, the Arabic-translated version of the TNL-2 was administered to 200 typically developing Arabic-speaking Egyptian children ranging in age from 4 years to 15 years and 11 months for validation. The participants were categorized according to their age into ten groups and their scores were analyzed. Face validity was assessed by asking five expert phoniatricians to review the Arabic version of the TNL-2 and complete a questionnaire that assessed the test's effectiveness in measuring different narrative skills. Results: A statistically significant difference was found when comparing the TNL-2 scores among the age groups under study. In addition, there was a significant correlation between standardized Arabic language test scores and the total comprehension and total production subtests' raw scores of the TNL-2. The test-retest reliability and inter-rater agreement demonstrated a high level of reliability and inter-rater agreement. Experts have reached a consensus that the Arabic version of the TNL-2 is capable of evaluating the primary microstructural and macrostructural components of Arabic narratives. Furthermore, it can provide insights into the overall narrative skills of Egyptian Arabic-speaking children. Conclusion: The Arabic-translated version of the TNL-2 demonstrated validity and reliability as an instrument for assessing narrative language comprehension and production skills in Arabic-speaking Egyptian children. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, there has been a rise of TikTok video usage and sharing worldwide. Meanwhile, the 2018 Cyber Crime Law has been activated against the so-called women TikTokers in Egypt who were accused and arrested for violating 'family values' and 'inflaming debauchery'. Public opinion expressed that media control is a grey area that includes ambiguous description of these violations. Social scrutiny became viral on social media platforms, inciting a debate over the prosecution of those women. This article is a case study that explores the play behaviour of women TikTok users in Egypt. Through employing a content analysis method, it seeks to find out whether users resist or adapt to the strict media control. Findings revealed that women TikTok users have several motives for their adopted behaviours, such as the fear of missing out (FoMO) and self-expression. Audiences who interpreted the behaviours TikTok women adopted as immoral used hashtags for social activism and generated content to oppress women based on gender rather than fairly evaluating their play behaviours. The research highlights key practices that women TikTok users are currently using in order to adapt to the vague 'Egyptian family values and morals'. Whether mimicking a meme, performing and/or singing, women TikTok users have been considering their conservative cultural context carefully to avoid the severe consequences that pervious women TikTokers have faced. Furthermore, women TikTok users are reluctant to boldly resist the strict media control in Egypt. Instead of using controversial sex appeal, they resort to using humour for garnering views and utilizing the platform's entertainment nature. [ABSTRACT FROM AUTHOR]

Background: Breast cancer (BC) is one of commonest malignancies among females. Many factors play a role in breast cancer like age at menarche and menopause, breastfeeding, physical activity, and dietary habit. However, genetics still play a significant role as a key player in breast cancer occurrence. Objectives: This research aimed to assess the gene expression of Lnc RNAs AK058003 and to analyze their dysregulation with clinical features in Egyptian BC patients. Methods: A case-control research was done with 27 breast cancer patients ages 30 to 80 years old at Beni-Suef University Hospital, Clinical Pathology Department & Oncology Department .The average participation ages of 27 patients were matched with 27 healthy controls. Using the qRT-PCR kit, we detected LncRNAs AK058003 gene expression levels in the blood. Results: BC patients had a higher level of LncRNAs AK058003 gene expression than healthy controls (P =0.025), there was a correlation between LncRNAs AK058003 and family history (P- value=0.010). The sensitivity and specificity of AK058003 is 74.1% and 77.8% respectively at cut off value 0.42 (P=0.025) was found among breast cancer. The level of the gene expression was not linked to patient age, parity, or grade & type of BC (P>0.05). Conclusion: There was a significant association between LncRNAs AK058003 expression level in the blood of BC females, but further research is needed to completely understand LncRNA's molecular mechanisms for future incidence and prognosis. [ABSTRACT FROM AUTHOR]

Background: Pelvic organ prolapse (POP) is a gynecological disease significantly associated with older age. A higher prevalence of women with symptomatic POP showed physical and emotional distress, negatively affecting their quality of life (QoL). The most widespread tool used is the prolapse quantification system (POP-Q) of the International Continence Society (ICS). The aim of this study was to evaluate the role of ultrasound (U/S) compared to POP-Q for the detection and quantification of POP in the anterior (urinary bladder) and apical (cervix/vaginal vault) compartments of the pelvic floor in Egyptian women. Results: The current study revealed that among 83 women, 53 had POP with a mean age of 50.83 years, 96.2% had anterior compartment prolapse (either alone or with apical compartment prolapse), 52% had apical compartment prolapse (either alone or with anterior compartment prolapse), 47.2% had anterior compartment prolapse only, and 3.7% had apical compartment prolapse only. There was a strong agreement (almost linear) between (POP-Q) and U/S in detecting significant pelvic organ prolapse in the anterior compartment (Kappa value 0.925, P < 0.001) and the apical compartment (Kappa value 0.945 and P < 0.001). With higher value of sensitivity and specificity, our study assigned significant anterior compartment prolapse using a cutoff value of 0 for point Ba of POP-Q and −11.5 for bladder neck descent at valsalva using U/S. Conclusions: Pelvic floor ultrasound provides general and detailed anatomical overview of the pelvic floor as well as detection and assessment of the POP in anterior and middle compartments. [ABSTRACT FROM AUTHOR]

Background: Syntaxin 1A is a member of a membrane-integrated nervous system-specific protein superfamily involved in the neuromediator release from synaptic vesicles and one of the proteins included in axonal integrity. Studies that discussed the role of Syntaxin 1A in multiple sclerosis are few and limited. Gene studying sometimes shows unexpected results in different populations. The aim of this work was to investigate Syntaxin 1A genetic polymorphism (rs1569061) in a sample of Egyptian patients with MS and the relation between Syntaxin 1A gene polymorphism and disease course and disability. A case–control study included 150 subjects; 75 Egyptian MS patients of different clinical courses and 75 age and sex matched healthy controls. Patients were subjected to clinical evaluation, assessment of disability, and cognition. Both patient and control groups were subjected to Syntaxin 1A genotyping. Results: There was no significant difference between different genotypes distribution for Syntaxin 1A (rs 1569061) between MS patients and controls. No significant difference was found between genotypes and allele distribution for Syntaxin 1A (rs 1569061) among cases of MS regarding EDSS or results of BICAMS). There was no statistically significant difference between syntaxin genotypes among cases of MS regarding demographic or clinical characteristics of the disease. Conclusion: Here we show no statistically significant difference between MS patients and control regarding Syntaxin 1A genotypes and different alleles. Syntaxin 1A genotypes have no impact on clinical characteristics of the disease, disability, or cognition. These negative findings open the floor for the study of other MS related genes in Egypt. [ABSTRACT FROM AUTHOR]

Background: Inflammation has been demonstrated to play a pathophysiological function in schizophrenia. Raised interleukin-6 (IL-6) levels have been the most consistently linked to schizophrenia. It was hypothesized that IL-6 contributed to the development of both adverse and beneficial symptoms. The aim of the study was to estimate the level of serum IL-6 in patients with schizophrenia and its relation to positive in addition to negative symptoms. Patient and methods: This case–control descriptive cross-sectional study was conducted on 40 patients, divided into two groups: 20 individuals in Group A (patients group) were treatment-naive for their first episode of schizophrenia, and 20 volunteers in Group B (control group) were matched for gender and age to the patient group. Both groups were evaluated for their serum interleukin-6 levels using the ELISA method. Patients and controls were recruited from the Okasha Institute of Psychiatry, Faculty of Medicine, and Ain Shams University Hospitals. Results: Cases with schizophrenia who were experiencing their first episode and had not yet begun any form of therapy had a considerably higher mean serum IL-6 level compared to the healthy control group. Conclusion: The level of serum interleukin 6 in first-episode treatment-naïve individuals with schizophrenia is higher than that of healthy controls, revealing a probable underlying immunological pathology. However, serum interleukin-6 levels were not significantly correlated with positive, negative, or general psychopathology symptoms. [ABSTRACT FROM AUTHOR]

Metabolic syndrome (MetS) is defined as a cluster of glucose intolerance, hypertension, dyslipidemia, and central obesity with insulin resistance. The role of gut microbiota in metabolic disorders is increasingly considered. To investigate the effects of probiotic supplements and hypocaloric high fiber regimen on MetS in obese Egyptian women. A longitudinal follow-up intervention study included 58 obese Egyptian women, with a mean age of 41.62 ± 10.70 years. They were grouped according to the criteria of MetS into 2 groups; 23 obese women with MetS and 35 ones without MetS. They followed a hypocaloric high fiber regimen weight loss program, light physical exercise, and received a probiotic supplement daily for 3 months. For each participating woman, blood pressure, anthropometric measurements, basal metabolic rate (BMR), dietary recalls, laboratory investigations, and microbiota analysis were acquired before and after 3 months of follow-up. After intervention by the probiotic and hypocaloric high fiber regimen and light exercise, reduction ranged from numerical to significant difference in the anthropometric parameters, blood pressure, and BMR was reported. All the biochemical parameters characterized by MetS decreased significantly at p ≤ 0.05–0.01. Before the intervention, results revealed abundant of Bacteroidetes bacteria over Firmicutes with a low Firmicutes/Bacteroidetes ratio. After the intervention, Log Lactobacillus, Log Bifidobacteria, and Log Bacteroidetes increased significantly in both groups, while Log Firmicutes and the Firmicutes/Bacteroidetes Ratio revealed a significant decrease. In conclusion, this study's results highlight a positive trend of probiotics supplementation with hypocaloric high-fiber diets in amelioration of the criteria of the Mets in obese Egyptian women. [ABSTRACT FROM AUTHOR]

Background: Adolescent substance use is a major problem that has serious medical, psychological, and legal consequences later in life. Substance use disorder is closely linked to deficits in executive functions. Impaired executive functions (EFs) have been linked to all stages of the substance use disorder (SUD) life cycle, increasing the likelihood of commencing use, escalating use more quickly, and increasing the likelihood of relapsing following treatment. The current study aimed at evaluating of the executive functions and quality of life in a sample of adolescent Egyptian males with substance use disorder. Results: A significantly higher mean Trail Making Test-A, B (TMT-A and TMT-B) scores among studied cases than the control group (equals lower executive functions) with a mean score of TMT-A is 74.38 versus 63.2 among controls and for TMT-B; the mean score for control is 97.22 versus 142.04 among cases. A statistically significant difference between the case and control groups on all quality of life scores measuring the following domains: general health and well-being, physical health, psychological health, social interactions, and the environment, also there has been a negative correlation between TMT-A and the environmental domain (r = − 0.279) and TMT-B with the same variable (r = − 0.414). Conclusions: Substance use disorders are a major health problem among youth. Deficits in executive functions are strongly associated with adolescent substance use. The more affected executive functions are associated with more affected quality of life of these patients. [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]

Hashimoto's thyroiditis (HT) and Graves' disease (GD) susceptibility depends on a complex interaction between environmental and genetic factors. Genes for tumor necrosis factor alpha (TNF-α) and toll-like receptors (TLRs) have been incorporated into the pathophysiology of autoimmune disorders. Our aim is to assess the association between TLR7 (rs179009) and TNF-α (rs1800629) polymorphisms and susceptibility to autoimmune thyroid disorders. One-hundred ninety-nine individuals, divided into 68 HT patients in group I, 57 GD patients in group II, and 74 age- and gender-matched healthy subjects in group III, underwent laboratory investigations, including the detection of TLR7 and TNF-α polymorphisms using real-time PCR technique. TLR7 (rs179009) genotypes, A/G and G/G, were significantly more prevalent in HT patients (group I) compared to normal controls. Meanwhile, TNF-α (rs1800629) genotypes in GD patients (group II) showed a six fold increase in the risk of the disease in the G/A and A/A genotypes. Our findings propose the fact that the polymorphisms of TLR7 (rs179009) play a role in the susceptibility and the development of Hashimoto's thyroiditis, whereas TNF-α (rs1800629) polymorphisms play a role in the susceptibility and development of Graves' disease. [ABSTRACT FROM AUTHOR]

Background: Familial hypercholesterolemia (MIM: PS143890) is a genetic disorder characterized by an increase in blood cholesterol. LDLR is one of the genes which their defect contributes to the disorder. Affected individuals may carry a heterozygous variant or homozygous/compound heterozygous variants and those with biallelic pathogenic variants present more severe symptoms. Method: We report an Egyptian family with familial hypercholesterolemia. Both the proband and parents have the disorder while a sibling is unaffected. Exome sequencing was performed to identify the causal variant. Results: LINE‐1 insertion in exon 7 of LDLR was identified. Both parents have a heterozygous variant while the proband has a homozygous variant. The unaffected sibling did not carry the variant. Discussion: This insertion may contribute to the high prevalence of hypercholesterolemia in Egypt and the finding underscores the importance of implementing mobile element insertion caller in routine bioinformatics pipeline. [ABSTRACT FROM AUTHOR]

Background: Sexual dysfunction (SD) is a common, yet underdiagnosed problem in Parkinson Disease (PD) patients. It can negatively impact their quality of life (QoL) and clinical outcome. we tried to assess SD in a group of Egyptian PD patients. Methods: The study is a case–control, cross-sectional study that included 200 participants, consisting of 100 PD patients and 100 matched healthy controls. Social, demographic information, and clinical variables were collected from both groups. Sexual functions were assessed using the Arabic Female Sexual Function Index (ArFSFI), and the Arabic version of International Index of Erectile Function (IIEF). Results: Women with PD scored worse on FSFI total score compared to controls (p < 0.001). Regarding the FSFI domains, they scored significantly lower in individual domains of desire (p < 0.001), arousal (p < 0.001), lubrication (p = 0.006), orgasm (p < 0.001), satisfaction (p < 0.001), and pain (p = 0.003), compared with controls. Men with PD scored worse on IIEF total scores compared to controls (p < 0.001). They showed significantly worse scores of erectile functions (p < 0.001), orgasmic function (p < 0.001), sexual desire (p < 0.001), intercourse satisfaction (p < 0.001), and overall satisfaction (p < 0.001). Both groups reported significant effect of SD on their QoL. There was a significant correlation between disease severity and SD. Conclusion: SD is common in PD patients. It negatively impacts their QoL and partnership. Healthcare professionals should initiate conversations about SD with the patients and provide appropriate education and treatment options. [ABSTRACT FROM AUTHOR]

This article discusses a study on the prevalence of depression among older adult Egyptian males with subjective cognitive decline (SCD) and mild cognitive impairment (MCI). The study found that approximately 50% of participants in both groups had mild depression, while the prevalence of moderate depression was higher in the MCI group. There was no statistically significant difference in the prevalence of depression between the two groups. The study also explored correlations between cognitive test scores and depression scores, but no significant correlations were found. The article acknowledges limitations and provides a list of references to related research articles and studies. [Extracted from the article]

This article discusses a study conducted in Egypt that examines the patterns of glomerular injury in elderly patients. The study found that focal segmental glomerulosclerosis (FSGS) was the most prevalent type of glomerulonephritis in the biopsies taken from geriatric patients. Other types of glomerular injury observed included membranous glomerulonephritis, diabetic glomerulosclerosis, diffuse proliferative glomerulonephritis, and diffuse glomerulosclerosis. The article emphasizes the importance of accurate diagnosis through renal biopsy in elderly patients with kidney disease. The findings of this study, along with other studies conducted in different countries, highlight the prevalence and types of glomerular diseases in elderly populations. The authors stress the significance of renal biopsy in older patients to obtain accurate diagnoses and guide appropriate treatment. This information may be useful for researchers and healthcare professionals studying renal diseases in elderly patients, particularly in the Egyptian context. [Extracted from the article]

Egyptian writer Mona Prince's self- published 2012 memoir Revolution is My Name abounds with descriptions of transferring Tahrir Square into a domestic space during the 2011 Revolution: people nurturing fellow visitors and protestors; sharing of blankets, warm clothing and mattresses; cooking and eating; distributing Coca- Cola, endless cups of tea, cigarettes; and nursing the injured who clashed with the police. In one point in her chronicling of her political participation, she describes moving one of her friend's mattresses out into the square and accepting food from whoever is offering it to her. She also details the square being cleaned by women of the elite class, heralding, in Prince's imaginings, "a new people." Focusing on descriptions of the cleaning of the square, this article argues that Prince expands domesticity's political function while overlooking class and religious biases and blindness that undergird her theorizations of it. This blindness, I argue ultimately undermines the revolution's attempt at total rupture from the unjust state regime of the past and extends insights into the entanglement of power, oppression and political resistance. Given that theorizations of cleanliness have been mobilized by the colonial project as an alibi for the gendered and racialized inequality of colonialism (and neocolonialism), cleaning here raises the specter of colonialism and highlights its mobility to function as a tool to measure complex class ambivalences. [ABSTRACT FROM AUTHOR]

Background: Covert cerebral small vessel disease (cCSVD) is associated with many age-related morbidities with little available data regarding the pathophysiology and role of genetics in it. This study aims to investigate the genetic load in a sample of Egyptian patients with cCSVD. Results: Thirty patients with cCSVD were recruited and underwent cognitive, gait, sphincter assessment, magnetic resonance imaging (MRI) brain, and blood sampling for whole exome sequencing. The mean age for the patients was 65.93 ± 8.8 with male patients representing 63.33% of the studied sample. The major risk factor was hypertension followed by diabetes mellitus, dyslipidaemia, and smoking. The main presenting symptom was cognitive impairment, found in 60% of the patients and the mean duration of symptoms was 2.1 ± 1.12 years. Two out of thirty patients were positive for a known pathogenic gene (NOTCH3 and COL4A1) despite the absence of family history in one representing 6.7% of the entire studied sample. Meanwhile, three patients had variant genes not previously linked to cCSVD. Conclusions: Whole exome sequencing and genetic studying of patients with cCSVD is of utmost importance as the genetic load is underestimated in the Egyptian population. [ABSTRACT FROM AUTHOR]

Long noncoding RNAs have been shown to be involved in a myriad of physiological and pathological pathways. To date, malignant pleural mesothelioma (MPM) is considered an extremely aggressive cancer. One reason for this is the late diagnosis of the disease, which can occur within 30–40 years of asbestos exposure. There is an immense need for the development of new, sensitive, inexpensive and easy methods for the early detection of this disease other than invasive methods such as biopsy. The aim of this study was to determine the expression of circulating lncRNAs in mesothelioma patient plasma to identify potential biomarkers. Ten previously identified lncRNAs that were shown to be aberrantly expressed in mesothelioma tissues were selected as candidates for subsequent validation. The expression of the ten selected candidate lncRNAs was verified via quantitative PCR (qPCR) in human plasma samples from mesothelioma patients versus healthy controls. The expression levels of circulating GAS5, SNHG8 and MALAT1 were significantly greater in plasma samples from patients than in those from controls. The ROC analysis of both MALAT1 and SNHG8 revealed 88.89% sensitivity and 66.67% specificity. The sensitivity of these markers was greater than that of GAS5 (sensitivity 72.22% and specificity 66.67%). The regression model for GAS5 was statistically significant, while that for SNHG8 and MALAT1 was not significant due to the small sample size. The area under the curve (AUC) of the three ROC curves was acceptable and significant: 0.7519 for GAS5, 0.7352 for SNHG8 and 0.7185 for MALAT1. This finding confirmed their ability to be used as markers. The three lncRNAs were not affected by age, sex or smoking status. The three lncRNAs showed great potential as independent predictive diagnostic biomarkers. Although the prediction model for MALAT1 did not significantly differ, MALAT1 was significantly expressed in patients more than in controls (p = 0.0266), and the recorded sensitivity and specificity were greater than those of GAS5. [ABSTRACT FROM AUTHOR]

Background: Even though current therapeutic approaches have significantly increased the longevity and standard of living for children suffering from cystic fibrosis (CF), the crucial psychological components of this illness have not received the same level of attention as other chronic illnesses. The aim of the research was to assess depression, anxiety, and hopelessness in cystic fibrosis-affected children and their relation to the duration of illness. In this study, we compared 40 healthy control children between the ages of 7 and 12 with 40 cystic fibrosis children who were matched for age and sex. All patients had detailed clinical and psychometric evaluations using the Children's Depression Inventory (CDI), the Anxiety Scale for Children (ASC), and the Hopelessness Scale for Children (HSC). Results: The CDI, ASC, and HSC revealed a significant difference between both groups. Positive correlations between depression, anxiety, and hopelessness and disease duration were found. Conclusions: Patients with CF experienced significantly increased depression, anxiety, and hopelessness, and there is an association between these symptoms and the duration of the illness. We advise making psychiatric screening a standard part of evaluating and monitoring CF patients. [ABSTRACT FROM AUTHOR]

Background: Globally, the burden of maternal malnutrition remains an enormous public health problem; malnourished pregnant women are at increased risk of having low-birth-weight (LBW) infants. Several reports suggest a possible association between malnutrition among lactating mothers and the production of smaller quantities of breast milk. Many women have incorrect nutrition knowledge during pregnancy due to false beliefs derived from popular practices. Our study was conducted to assess nutritional knowledge, myths, and practices among Egyptian women during pregnancy and lactation. Methodology: A pretested 2-page interview questionnaire was used to collect data from the study participants after written informed consent was obtained from them after clarification of the study's aim. Obstetrics and gynecology experts collected the data from pregnant females who agreed to participate in private and university hospital antenatal care clinics in Cairo, Egypt. Results: A total of 468 pregnant females completed the interview questionnaire. The mean knowledge score was 5 ± 3, with a median score of 5 and an IQR of 3–7, and the mean holding myths score was 3 ± 2, with a median score of 2 and an IQR of 2–4. Regarding the correct answers to the knowledge questions, more than 70% of the participants correctly answered that during the first six months of life, breast milk is the only food a baby requires, and less than 20% of them correctly answered that caffeine consumption could provoke premature birth. Regarding the holding myths questions, more than half of the participants held the myth that drinking moghat and helba increases the breast milk supply. We found that the most common source of knowledge during pregnancy and lactation among the participants was family and friends' advice (60%), followed by others (doctors, previous education in school or university) (45%). Conclusion: Among a sample of Egyptian women, more than half held at least one myth about nutrition and diet during pregnancy and breastfeeding, so health education at antenatal outpatient clinics should be directed toward those myths to correct them. Older women with sufficient family income showed significantly higher knowledge scores than others. [ABSTRACT FROM AUTHOR]

Coagulase-negative staphylococci (CoNS) are a group of gram-positive staphylococcal species that naturally inhabit the healthy human skin and mucosa. The clinical impact of CoNS-associated infections has recently been regarded as a challenge for diagnosis and therapeutic options. CoNS-associated infections are primarily caused by bacterial resistance to antibiotics and biofilm formation. As antibiotics are still the most used treatment, this problem will likely persist in the future. The present study aimed to investigate the resistance and virulence of CoNS recovered from various acne lesions and explore their genetic basis. Skin swab samples were collected from participants with acne and healthy skin. All samples underwent conventional culture for the isolation of CoNS, MALDI-TOF confirmation, antibiotic susceptibility, and biofilm formation testing. A total of 85 CoNS isolates were recovered from the samples and preliminarily identified as Staphylococcus epidermidis. Isolates from the acne group (n = 60) showed the highest rates of resistance to penicillin (73%), cefoxitin (63%), clindamycin (53.3%), and erythromycin (48%), followed by levofloxacin (36.7%) and gentamycin (31.7%). The lowest rates of resistance were observed against tetracycline (28.3%), doxycycline (11.7%), and minocycline (8.3%). CoNS isolated from mild, moderate acne and healthy isolates did not show strong biofilm formation, whereas the isolates from the severe cases of the acne group showed strong biofilm formation (76.6%). Four extensively drug-resistant and strong biofilm-forming staphylococcal isolates recovered from patients with severe acne were selected for whole-genome sequencing (WGS), and their genomes were investigated using bioinformatics tools. Three of the sequenced genomes were identified as S. epidermidis; however, isolate 29AM was identified as Staphylococcus warneri, which is a newly emerging pathogen that is not commonly associated with acne and was not detected by MALDI-TOF. All the sequenced strains were multidrug-resistant and carried multiple resistance genes, including blaZ, mecA, tet(K), erm(C), lnuA, vgaA, dfrC, fusB, fosBx1, norA, and vanT, which were found to be located on plasmids and chromosomes. Virulence features were detected in all genomes in the presence of genes involved in adherence and biofilm formation (icaA, icaB, icaC, sdrG, sdrH, atl, ebh, and ebp). Only the S. warneri isolate 29AM contained immune evasion genes (capB, capC, acpXL, and manA), an anti-phagocytosis gene (cdsA), and other unique features. As a result of their potential pathogenicity and antibiotic resistance, CoNS must be monitored as an emerging pathogen associated with acne infections. To the best of our knowledge, this is the first report to isolate, identify, and correlate S. warneri with severe acne infections among Egyptian patients using WGS and bioinformatic analysis. [ABSTRACT FROM AUTHOR]

Introduction: Benign auto-immune illnesses include Evans syndrome (ES) and auto-immune hemolytic anemia (AIHA). Despite being benign in nature, the patients' livers are burdened by the disease's chronicity and the accompanying problems beyond the course of treatment. An additional burden stems from HCV infection, of which a significant proportion of Egyptians are positive. The purpose of this study was to identify the hepatotoxicity risks and the variables that influence the prognosis and survival of patients with AIHA/ES. There are 126 AIHA patients in this observational study, which is retrospective. From June 2009 to March 2021, patients visited the Haematology Unit of the Oncology Centre in Egypt. One hundred and sixteen patients have available data. Results: There was no significant difference between primary and secondary AIHA groups as regards baseline hemoglobin (Hb), bilirubin, LDH, or reticulocyte count. Thirty-four patients (29.31%) had HCV-positive tests and 1 patient (0.9%) had HBV. There was no difference between HCV-positive and negative cases as regards mean Hb concentration, mean platelet, or immune markers (P > 0.05). AIHA patients with HCV-positive showed a significantly higher relapse rate (56%) than HCV-negative patients (32%) (P = 0.034). HCV positivity and low platelet counts at diagnosis were poor predictors for overall survival (OS) (P 0.022 and 0.04, respectively). Median OS was significantly better in patients with no viral hepatitis infection (1101 days, 95% CI 592–2068) than in patients with positive HCV infection (521, 95% CI 326–1325) (P = 0.019). Conclusions: Azathioprine is the least hepatotoxic in AIHA patients under treatment. Viral hepatitis represents a superadded damage to the liver besides AIHA concerning clinical characteristics and outcomes. [ABSTRACT FROM AUTHOR]

Several studies have shown association of single nucleotide polymorphisms (SNPs) of hepcidin regulatory pathways genes with impaired iron status. The most common is in the TMPRSS6 gene. In Africa, very few studies have been reported. We aimed to investigate the correlation between the common SNPs in the transmembrane protease, serine 6 (TMPRSS6) gene and iron indicators in a sample of Egyptian children for identifying the suitable candidate for iron supplementation. Patients and methods One hundred and sixty children aged 5–13 years were included & classified into iron deficient, iron deficient anemia and normal healthy controls. All were subjected to assessment of serum iron, serum ferritin, total iron binding capacity, complete blood count, reticulocyte count, serum soluble transferrin receptor and serum hepcidin. Molecular study of TMPRSS6 genotyping polymorphisms (rs4820268, rs855791 and rs11704654) were also evaluated. Results There was an association of iron deficiency with AG of rs855791 SNP, (P = 0.01). The minor allele frequency for included children were 0.43, 0.45 & 0.17 for rs4820268, rs855791 & rs11704654 respectively. Genotype GG of rs4820268 expressed the highest hepcidin gene expression fold, the lowest serum ferroportin & iron store compared to AA and AG genotypes (p = 0.05, p = 0.05, p = 0.03 respectively). GG of rs855791 had lower serum ferritin than AA (p = 0.04), lowest iron store & highest serum hepcidin compared to AA and AG genotypes (p = 0.04, p = 0.01 respectively). Children having CC of rs11704654 had lower level of hemoglobin, serum ferritin and serum hepcidin compared with CT genotype (p = 0.01, p = 0.01, p = 0.02) respectively. Conclusion Possible contribution of SNPs (rs855791, rs4820268 and rs11704654) to low iron status. [ABSTRACT FROM AUTHOR]

Background: Hepatocellular carcinoma (HCC) is the prevailing primary liver tumor. To pick HCC at the initial stages is quite strenuous, despite the advent of serum biomarkers, mainly alpha-fetoprotein (AFP), to predict the development and progression of HCC. One proposed biomarker for the diagnosis of HCC is micro-RNA 486-5p (miRNA 486-5p). Hence, the current study was conducted to interrogate the role of miRNA 486-5p in the diagnosis of HCC in a cohort of Egyptian patients with hepatitis C virus (HCV) related liver cirrhosis (LC). This case–control study included twenty-five patients with HCC as studied cases and twenty-five patients with LC as controls. Patients in both groups were classified according to the Child–Pugh score. HCC patients were further classified according to the Barcelona Clinic Liver Cancer (BCLC) classification. Results: MiRNA 486-5p was found to be statistically notably elevated in patients with HCC than in those with LC. It was found to significantly correlate with portal vein invasion. Conclusions: Serum miRNA 486-5p could be a particularly sensitive biomarker in the diagnosis of HCC as well as prediction of portal vein invasion, as firmly advocated by this study. [ABSTRACT FROM AUTHOR]

Background: Isolated growth hormone deficiency (IGHD) is a hereditary disorder that causes significant short stature. GHD has a reported incidence of 1/4000–1/10,000 births. It is caused by mutations in the major somatotroph axis genes, involving GH1, codes for growth hormone, GHSR, and GHRHR, codes for growth hormone secretagogue receptor and growth hormone-releasing hormone receptor, respectively. Aims of the study: The present study aims to examine the clinical phenotype and investigate the genetic etiology of ten Egyptian patients with type I isolated growth hormone insufficiency. Patients and methods: Patients recruited for the study were clinically diagnosed by two provocation tests and were subjected to a thorough history, clinical examination, and anthropometric measurements. Sanger sequencing and mutational analysis of the three genes, GH1, GHSR, and GHRHR, was our approach, performed in all enrolled IGHD patients. The variants identified were analyzed using the biological, population, sequence variants, and clinical genetics databases. Prediction of the pathogenicity of the novel variants was done by in silico prediction tools following the American College of Medical Genetics and Genomics (ACMG) guidelines. Results: Sanger sequencing revealed a previously reported pathogenic mutation (NM_000823.4: c.1069C > T; p.Arg357Cys) in the GHRHR gene in one patient and a novel frameshift variant (NM_198407.2: c.1043dup; Ser349Leu fs*6) in the GHSR gene in another patient. This is the fourth report highlighting the autosomal dominant inheritance of the GHSR mutation as a cause of isolated growth hormone deficiency. A number of previously reported variants, but of rare frequency, were identified in this study. In our IGHD cases, 90% of the patients were underweight, 50% had anemia, and 80% showed hypovitaminosis D. Conclusion: Our findings broaden the mutational spectrum underlying the IGHD in Egyptian patients and point out the importance of mutation screening of the GHSR and GHRHR genes. This study also acknowledges the autosomal dominant mode of inheritance of the GHSR mutation as a cause for dwarfism. [ABSTRACT FROM AUTHOR]

Objective: The simultaneous presence of celiac disease and type 1 diabetes (T1DM) is coupled with more hazards of comorbidities and complications. This current study aimed to screen for celiac disease in Egyptian children with type 1 diabetes and evaluate its impact on glycemic control. Methods: A cross-sectional study was verified with 200 Egyptian children diagnosed with T1DM and having a diabetic duration of less than five years. Testing for anti-tissue transglutaminase IgA (tTG-IgA), anti-tissue transglutaminase IgG (tTG-IgG), anti-Endomysial IgA (EMA), and Hb A1c levels were done. Results: The serological screening revealed that 11 cases (5.5%) tested positive; 8 children with T1DM (4.0%) showed tTG-IgA antibodies ≥ 10 times the upper limit of normal (ULN) with at least one symptom; and 3 cases (1.5%) had levels between 20 and 50 IU/ml (considering a cut-off point of 10 U/ML for positive results). Intestinal biopsy was performed for these three cases, with one case detected to have subtotal villous atrophy, resulting in an overall prevalence of celiac disease in T1DM as 4.5%. Children with positive screening exhibited a higher insulin dose, a higher HbA1c, an increased frequency of hypoglycemic attacks, and recurrent DKA compared to negative cases. A negative correlation was detected between tTG-IgA antibodies with height Z score and hemoglobin level, while a positive correlation was found between tTG-IgA antibodies and HbA1c level. Conclusion: Undiagnosed celiac disease in children with T1DM negatively impacted metabolic control and affected their general health. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to assess the sexual and the reproductive functions in males post COVID-19 infection in Beni-Suef Governorate. Methods: One hundred men were recruited in the current study. All participants were assessed by the Arabic validated version of the International Index of the Erectile Function 5 (ArIIEF-5), semen analysis, and Hospital Depression and Anxiety Scale (HADS). Finally, morning testosterone serum level was measured. Results: There were significant decreases in the sperm total motility, the ArIIEF-5 score, and serum total testosterone in the post COVID-19 patients after 3 months when compared to the controls. However, there were significant increases in the sperm total motility, the ArIIEF-5 score, and serum total testosterone in the post COVID-19 patients after 6 months group when compared to the post COVID-19 patients after 3 months group. Moreover, there was a significant increase in the HADS score in the post COVID-19 patients after 3 months when compared to the controls. In contrast, there was a significant decrease in the HADS score in the post COVID-19 patients after 6 months when compared to the post COVID-19 patients after 3 months. Conclusion: Our study had shown temporary impairment of sexual and reproductive functions in post COVID-19 convalescent males especially after 6 months from the onset of the infection. [ABSTRACT FROM AUTHOR]

Sleep is a major concern in Down syndrome children. Obstructive sleep apnea, delayed sleep onset, night-time and early awakenings have been reported contributing to the cognitive and behavioral outcomes. The aim is to evaluate sleep related difficulties in Down syndrome young children. A questionnaire of sleep related difficulties was translated and validated into Arabic language then was filled in by caregivers of 45 Down syndrome and 48 normal children. The questionnaire consisted of sections related to snoring, breathing difficulties, mouth breathing, upper respiratory tract infections, sleep position, restless sleep and frequent awakening, and daytime behavior. The results show highly significant differences between the total and subtotal questionnaire scores with higher scores in the control group. The questionnaire has a good reliability. Test–retest reliability of the questionnaire revealed a significant positive correlation in the total questionnaire and all the subitems except for the 7th subitem of the daytime behavior which showed no significant correlation. The questionnaire showed 100% sensitivity and 70.8% Specificity with at cut-off value of 8.5. The sleep related difficulties questionnaire has good psychometric properties and could detect significant sleep problems in Down syndrome children. [ABSTRACT FROM AUTHOR]

Breast cancer is the most common type of cancer in Egyptian females. Polymorphisms in the angiogenesis pathway have been implicated previously in cancer risk and prognosis. The aim of the current study was to determine whether certain polymorphisms in the genes of vascular endothelial growth factor A (VEGFA), vascular endothelial growth factor receptor 2 (VEGFR2), vascular endothelial growth inhibitor (VEGI), and hypoxia-inducible factor-1α (HIF1A) associated with breast cancer development. The study included 154 breast cancer patients and 132 apparently healthy age-matched females as a control group. VEGFA rs25648 genotyping was performed using (ARMS) PCR technique; while VEGFR2 rs2071559, VEGI rs6478106, and HIF-1α rs11549465 were genotyped by the PCR–RFLP method. Serum levels of VEGF, VEGFR2, VEGI, and HIF1A proteins in breast cancer patients and controls were measured by ELISA. There was a significant association between the VEGFA rs25648 C allele and breast cancer risk (OR 2.5, 95% CI 1.7–3.6, p < 0.001). VEGFA rs25648 C/C genotype was statistically significantly higher in breast cancer patients vs. control (p < 0.001). Participants with the T/T and T/C VEGFR2 rs2071559 genotypes had 5.46 and 5 higher odds, respectively, of having breast cancer than those with the C/C genotype. For the VEGI rs6478106 polymorphism, there was a higher proportion of C allele in breast cancer patients vs. control (p = 0.003). Moreover, the C/C genotype of VEGI rs6478106 was statistically significantly higher in breast cancer patients vs. control (p = 0.001). There was no significant difference in genotypes and allele frequencies of HIF1A rs11549465 polymorphism between breast cancer cases and control individuals (p > 0.05). Serum levels of VEGFA, VEGI, and HIF1A were considerably greater in women with breast cancer than in the control (p < 0.001). In conclusion, the genetic variants VEGFA rs25648, VEGFR2 rs2071559, and VEGI rs6478106 revealed a significant association with increased breast cancer risk in Egyptian patients. [ABSTRACT FROM AUTHOR]

Polymorphisms in genes coding folate-metabolising enzymes might alter the pharmacokinetics and sensitivity for methotrexate "MTX". The aim of the study aimed to investigate the influence of MTHFR C677T, DHFR19 Ins/del, GGH −401 C > T, and MTR A2756G polymorphisms on MTX toxicity and pharmacokinetics in Egyptian patients with Acute lymphoblastic leukaemia (ALL) or Non-Hodgkin lymphoma (NHL). Fifty adult Egyptian patients with ALL and NHL, treated with high dose MTX, were prospectively enrolled in the study. Clinical and biochemical data was collected objectively from medical records after each cycle of MTX. Plasma concentrations of MTX were measured after 72 h of initiation of infusion. Genotyping was done with a PCR-ARMS and PCR-RFLP assays. The MTHFR C677T T variants significantly increased the risk of leukopoenia, whereas the genotype MTHFR 677 C > T TT significantly associated with lymphocytopenia, thrombocytopenia, and anaemia. The genotype GGH-401 TT was significantly correlated with anaemia. Plasma MTX level was significantly higher in patients with MTR A2756G G variants. MTHFR polymorphism played the main role in MTX toxicities. The pharmacokinetics of MTX was affected by MTR polymorphism. GGH mutation was mainly concerned with anaemia. Pharmacogenetic testing are recommended to optimise MTX therapy. [ABSTRACT FROM AUTHOR]

Background and aim: A potentially fatal side effect of decompensated liver cirrhosis is ascites. One potentially dangerous consequence in cirrhotic individuals with ascites is spontaneous bacterial peritonitis (SBP). Diagnostic paracentesis is a method used to diagnose SBP, although it is an invasive procedure. Numerous noninvasive markers were investigated in SBP diagnosis. Thus, this study aimed to assess the clinical utility of the noninvasive markers for the diagnosis and treatment response in patients with SBP, namely the lymphocyte monocyte ratio (LMR), mean platelet volume (MPV), and absolute neutrophil count (ANC). Patients and methods: This study included 162 cirrhotic patients was conducted. They were divided into 2 groups, group I included 101 cirrhotic patients with SBP and group II included 61 cirrhotic patients without SBP. ascitic fluid sampling and complete blood count (CBC) including ANC, LMR and MPV were done. Results: There was a significant difference between the 2 groups as regard ANC and LMR (p<0.05). In SBP group there was a significant difference in ANC, LMR, MPV before and after the standard\antibiotic treatment. Absolute neutrophil count had sensitivity 79.21%, specificity 63.93% However, the LMR had sensitivity 91.09 %, specificity 68.85 % and MPV had sensitivity 83.17%, specificity 62.30%. When ANC, LMR and MPV were combined, the sensitivity was 91.10% and specificity was 91.80%. Conclusion: This study suggests that the ANC, MPV, and LMR may be utilized as noninvasive markers for the diagnosis of SBP and prediction of treatment response, enabling prompt detection of SBP to minimize its consequences. [ABSTRACT FROM AUTHOR]

Background and rationale: Hypothyroidism is a common condition of thyroid hormone deficiency, which is readily diagnosed and managed but potentially fatal in severe cases if untreated. Helicobacter pylori (H. pylori) infection has been associated with an increased risk of thyroid diseases (TDs) and it may cause some sort of mal absorption to thyroxine replacement therapy causing a treatment refractory state. Aim of work: The aim of the work is to estimate the prevalence of H. pylori in hypothyroid patients and its relation to unresponsiveness to treatment. Patients and method: We analyzed 211 hypothyroid patient on treatment. We estimate stool antigen for H. pylori and correlate it with other parameters in hypothyroid patients. Results: Two hundred and eleven (211) patients were included in this study, of these, 101/211 (47.9%) were euthyroid on treatment and 110/211 (52.1%) had refractory hypothyroidism with high dose of LT4. The mean age of patients in our study was 55.67 ± 13.53 years, with 151 (71.6%) female patients. In the current study, we noticed that prevalence of H. pylori was higher in treatment refractory hypothyroidism than euthyroid patients. Conclusions: This study suggested that there is a significant association between H. pylori infection and treatment-refractory hypothyroidism. And eradication of H. pylori may help in overcoming the issue of resistant to thyroxine therapy. [ABSTRACT FROM AUTHOR]

Background and Aim: COVID-19-related pulmonary inflammation is linked to elevated plasma levels of a group of proinflammatory cytokines. We aim to identify the association between IL-6 rs1800795, IL-17 rs2275913, and IL-37 rs3811046 gene polymorphisms and COVID-19 severity and prognosis. Methods: Two hundreds adult COVID-19-confirmed patients (100 patients with non-severe and 100 patients with severe or critical COVID-19) and 100 healthy individuals were enrolled in this cross-sectional study. Clinical and laboratory evaluations were performed, including liver and kidney functions, complete and differential blood counts, C-reactive protein, and D-dimer. Genotyping for IL-6 (rs1800795), IL-17 (rs2275913), and IL-37 (rs3811046) was conducted using allelic discrimination real-time PCR assay via TaqMan probes. The levels of IL-6, IL-17, and IL-37 were estimated by enzyme-linked immunosorbent assay (ELISA). Results: Serum levels of IL-6 and IL-17 were increased while IL-37 declined with ongoing COVID-19 severity. IL-6 rs1800795 genotypes and alleles did not differ significantly between the studied groups. Meanwhile, IL-17 rs2275913 GA (heterozygous) and AA (homozygous) genotypes and A allele showed significantly higher frequencies in the control group compared to those in the patients' groups and were proposed as protective factors against COVID-19 occurrence and increased severity. Notably, IL-37 rs3811046, GT and TT variants, and T allele were more prevalent in the patients' groups than in the control group and might be related to both disease occurrence and progression. Conclusion: Both GG genotype and G allele of IL-17 (rs2275913) and TT genotype and T allele of IL-37 (rs3811046) and their serum levels are potential risk factors for COVID-19 infection and severity, making them excellent disease management targets. [ABSTRACT FROM AUTHOR]

Background: Bipolar disorder (BD) is a common mental illness that is usually associated with significant morbidity causing critical impairment in socio-occupational functioning and even mortality. Social rhythm therapy (SRT) has been suggested as an adjunctive psychotherapy in BD treatment protocols, with its proposed benefits of accelerating recovery from bipolar episodes, delaying relapses, and upgrading patients' functioning. This study aimed to investigate the outcomes of combining SRT with pharmacological treatment, as compared to pharmacotherapy alone, in a sample of Egyptian BD patients. Sixty eligible bipolar patients were enrolled in this comparative study by convenience sampling and randomly divided into two groups for comparison; group I included 30 BD-I patients treated as usual (TAU) with pharmacological treatment only, while group II included 30 BD patients treated with social rhythm therapy in addition to the traditional psychotropic medications. Manic and depressive symptoms as well as socio-occupational functioning were assessed at baseline and after 3 months of treatment using the Mood Disorder Questionnaire (MDQ), Hamilton Depression Rating Scale (HDRS), and Socio-occupational Functioning Assessment Scale (SOFAS). Results: Patients treated with SRT therapy showed significant improvement in their manic and depressive symptoms as well as socio-occupational functioning after 3 months of treatment by 65.76%, 55.87%, and 52.5%, respectively. Linear regression analysis showed that the gender and age of the patient could significantly predict improvement of MDQ% in group II, while none of the studied variables could significantly predict the percentage of change in HDRS or SOFAS. Conclusion: SRT could be a promising adjunctive therapy promoting early recovery of BD patients compared to standalone pharmacological treatment. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovary syndrome (PCOS) is known as the most common endocrine/metabolic disorder in women of reproductive age. Long non-coding RNAs (lncRNAs) regulate a wide range of physiological and pathological processes. We designed this study to evaluate lncRNA H19 relative expression in patients with PCOS and to evaluate its impact on metabolic features and reproductive phenotypes of Egyptian women with polycystic ovaries. Material and methods: The case–control study enrolled 50 control groups and 50 patients, with PCOS. The selection of patients with PCOS depended on the diagnosis according to the Rotterdam Consensus (2004). The lncRNA H19 were measured by real-time quantitative polymerase chain reaction (RT-qPCR). Results: The lncRNA H19 level was significantly higher in the PCOS group (1.71 ± 0.48) compared to controls (0.924 ± 0.081). Furthermore, lncRNA H19 levels were significantly positively correlated with anthropometric and metabolic parameters including BMI, waist/hip ratio, TC, TG, LDL, FPG, FSI, HbA1c, and HOMA-IR. Regarding reproductive phenotypes features, hirsutism score, and AFC levels were significantly positively correlated with lncRNA H19 levels. The linear regression test revealed that BMI and AFC were the only parameters independently associated with lncRNA H19 among other studied parameters. Interestingly, receiver operating characteristic curve (ROC) analysis detected that the area under the curve (AUC) for the lncRNA H19 was 0.925 (95% CI = 0.856–0.955) with sensitivity = 96.4%, specificity = 96%, and the cutoff values (1.08). Thus, the predictive power of lncRNA H19 of PCOS was highly sensitive and specific. Conclusion: PCOS patients had significantly higher lncRNA H19 levels than controls. lncRNA H19 levels were significantly positively correlated with metabolic risk factors as well as clinical and laboratory features of PCOS. [ABSTRACT FROM AUTHOR]

Cerebral ischemic stroke (CIS) is a severe cerebral vascular event. This research aimed to evaluate the role of single-nucleotide polymorphisms (SNPs) of the lncRNAs MIAT rs2331291 and H19 rs217727 and epigenetic methylation in the expression patterns of serum lncRNA H19 in CIS Egyptian patients. It included 80 CIS cases and 40 healthy subjects. Serum MIAT expression levels decreased, whereas serum H19 expression levels increased among CIS compared to controls. For MIAT rs2331291, there were significant differences in the genotypic and allelic frequencies between the CIS and healthy subjects at p = 0.02 and p = 0.0001, respectively. Our findings illustrated a significantly increased MIAT T/T genotype frequency in hypertensive CIS compared to non-hypertensive CIS at p = 0.004. However, H19 rs217727 gene frequency C/C was not significantly higher in non-hypertensive CIS than in hypertensive CIS. The methylation of the H19 gene promoter was significantly higher in CIS patients compared to healthy subjects. The level of MIAT was positively correlated with serum H19 in CIS. Receiver operating characteristics (ROC) analysis revealed that serum MIAT and H19 have a high diagnostic potential for distinguishing CIS subjects from healthy ones. In conclusion, the MIAT-rs2331291 polymorphism might serve as a novel potential indicator of CIS. [ABSTRACT FROM AUTHOR]

Background: Elderly are one of the most heterogeneous and vulnerable groups who have a higher risk of nutritional problems. Malnutrition is prevalent among hospitalized elderly but underdiagnosed and almost undistinguishable from the changes in the aging process. The Geriatric Nutritional Risk Index (GNRI) is a tool created to predict nutrition-related complications in hospitalized patients. This study aims to measure the prevalence of nutritional risk using the GNRI among hospitalized elderly Egyptian inpatients and to determine the association between the GNRI and selected adverse clinical outcomes. Methods: A hospital-based prospective cohort study was conducted among 334 elderly patients admitted to a tertiary specialized geriatric university hospital in Cairo, Egypt from August 2021 to June 2022. Within 48 hours after hospital admission, socio-demographic characteristics, blood biomarkers, anthropometric measurements, and nutritional risk assessment by the GNRI score were obtained. Patients were divided into three groups based on their GNRI: high, low, and no nutritional risk (GNRI<92, 92-98, and >98) respectively. Patients were followed up for the occurrence of adverse outcomes during hospital stay (bed sores, Healthcare-Associated Infections (HAIs), hospital Length of Stay (LOS), and hospital mortality) and three months after discharge (non-improvement medical status, appearance of new medical conditions, hospital readmission and 90-day mortality). Multivariable regression and survival analysis were conducted. Results: The prevalence of high-nutritional risk was 45.5% (95% CI, 40%–51%). Patients with high risk had significantly longer LOS than those with no risk. The high-nutritional risk was significantly associated with the development of bed sores (Adjusted Odds Ratio (AOR) 4.89; 95% CI, 1.37–17.45), HAIs (AOR: 3.18; 95% CI, 1.48–6.83), and hospital mortality (AOR: 4.41; 95% CI, 1.04–18.59). The overall survival rate was significantly lower among patients with high-nutritional risk compared to those with no risk. Conclusion: GNRI is a simple and easily applicable objective nutritional screening tool with high prognostic value in this Egyptian sample of patients. The findings of this study signal the initiation of the application of this tool to all geriatric hospitals in Egypt. [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]

Background: Autophagy-related genes (ATGs), associated with autophagy, contribute to the pathogenesis of many illnesses, including cancer. ATGs' role in breast cancer (BC) is still under investigation. Therefore, the current study aimed to determine whether genetic variants in core ATGs correlate with BC prognosis and investigate their impact on protein plasma levels. Methods: This case–control study was carried out on 70 BC patients as well as 70 cancer-free controls in order to determine the association of these variants with BC risk. ATG10 (rs1864182) and ATG7 (rs1375206) polymorphisms were genotyped in whole blood samples using TaqMan SNP Genotyping Assays, and ATG7 and ATG10 levels in plasma were determined using ELISA. Results: The results revealed that ATG7 (rs1375206) might contribute to BC, as patients with the GG genotype displayed a substantial association with BC (OR = 3.23, 95% CI 1.12–9.5) as well as a significant increase in ATG7 protein expression. For ATG7 rs1375206, genotypes GG was significantly associated with increased BC risk; carriers of the G allele frequently have a bad prognosis compared to carriers of the CC genotype (OR of mortality equals 3.01). Serum ATG 7 in the breast cancer patients' group was significantly higher than that in the control group (p < 0.001). In contrast, carriers of the ATG10 (rs1864182) CC genotype were significant with a lower risk of BC (OR = 0.31, 95% CI 0.26–0.79) when compared with patients with AA genotype, while serum ATG 10 protein levels were decreased in patients carrying C allele (p < 0.05). Carriers of the C allele frequently have a good prognosis (OR of mortality equals 0.79) also the C allele were significantly less likely to have higher grade tumor (14.3% compared to 65.2% of A allele). Conclusions: Single gene polymorphisms (SNPs) within the ATG7 (rs1375206) and ATG 10 (rs1864182) are substantially correlated with BC among Egyptian females. Consequently, SNPs should be considered critical prognostic markers for distinguishing individuals with ATG7 (rs1375206) at elevated risk of developing BC as well as its progression from those with ATG 10 (rs1864182) at lower risk and the effect of these SNPs on its protein expression levels as ATG7 (rs1375206) polymorphism associated with decreased plasma ATG7 level, on the other hand, ATG 10 (rs1864182) polymorphism accompanied with increased ATG 10 plasma level. [ABSTRACT FROM AUTHOR]

Background: A more successful approach to reducing the incidence of Sudden Infant Death Syndrome (SIDS) was active caregiver education regarding safe sleep recommendations. Therefore, the purpose of this study was to assess the impact of an interventional safety program about SIDS on mothers' knowledge, attitude, and practice in order to enhance mothers' behaviors toward SIDS. Methods: Between December 1, 2019, and March 31, 2022, an interventional study was conducted in the family health care centers and units located in the Al Sharqia Governorate, Egypt. In this study, 144 mothers with infants under a year old were split into two equal groups. The researcher conducted structured self-designed questionnaire interviews with all included mothers. The first questionnaire focused on socio demographic and clinical characteristics of the infant, while the second one (pre/post intervention) assessed mothers' knowledge, attitudes, and practices regarding safety measures to prevent SIDS. Results: A highly statistically significant difference was found between them post-intervention where (90.3%, 26.4%), (87.5%, 23.6%), and (80.6%, 9.70%) of them had adequate total knowledge, attitude, and practice scores, respectively. There was no statistically significant difference between the two groups regarding total scores of knowledge, attitude, and practice pre-intervention where only (22.2%, 25.0%), (13.9%, 23.6%), and (12.5%, 16.7%) of them had adequate total knowledge, attitude, and practice scores, respectively. Conclusions: There is a major state of inadequate levels of knowledge, attitude, and practice toward SIDS & its prevention between infants? mothers and implementation of an interventional safety program leads to highly significant improvement. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) is a multifactorial neurodegenerative autoimmune disease with a varied clinical course and presentation, which is more frequent than ever in the Middle East. The aim of this work is to investigate potential predictors of MS progression in order to help in early diagnose and predict progressive course of the disease. Results: This is a retrospective case–control study conducted on a group of multiple sclerosis (MS) patients who developed secondary progression of the disease course (SPMS). The cases were matched with control MS patients who did not develop any disease progression (relapsing remitting MS (RRMS)). The matching was done for sex, and age with a ratio 1:1, total of 150 patients were included as cases and were matched with 150 control patients. Significant associations between MS progression and smoking, vitamin D deficiency, disease duration, delay in MS diagnosis, unemployment, site and number of lesions, and number of black holes were reported. About half of SPMS patients (53.3%) had 3 or more spinal lesions compared to only 1.4% of RRMS patients (p < 0.001). Moreover, about 76% of RRMS patients had no black holes in their radiological finding, while it was found that 35.3% of the SPMS patients had more than 5 black holes, compared to 8% of RRMS patients. Additionally, juxta-cortical site lesions were more frequent in SPMS than that in RRMS in a percentage 72.7 and 46%, respectively. Also, infra-tentorial lesions were found to be more frequent in SPMS group rather than RRMS group 92% and 78.7%, respectively. On the other hand, a lower SDMT scale was associated with a shorter time to SPMS diagnosis in the multivariate Cox regression analysis adjusted to baseline factors and 25-FWT (HR: 0.928, 95% CI: 0.906–0.95). Conclusions: MS secondary progression can be predicted among MS patients in routine practice comprising exposure history, clinical assessment, laboratory findings, and radiological examinations. [ABSTRACT FROM AUTHOR]

Background: Canned fish products are widely consumed in Egypt, particularly for protein-rich meals that are quick to prepare and low in calories. Canned fish products are contaminated with toxic metals from the fish itself or from canning materials during processing. Aim: To determine the residual levels of cadmium (Cd), lead (Pb), arsenic (As), mercury (Hg), aluminum (Al), and Tin (Sn) in some canned fish products obtained from retail shops in Mansoura, Egypt. Furthermore, noncarcinogenic health risks evaluation for the Egyptian population due to hazardous metal oral intake. Methods: One hundred canned fish products (20 each of herring, mackerel, salmon, sardine, and tuna) were collected from May to September 2023, and canned fish products were obtained from Mansoura city markets in Egypt. Samples were digested in a solution composed of 60% nitric acid and 40% perchloric acid, and then an atomic absorption spectrophotometer was used for the detection of selected toxic metals. Results: It was found that the residual level of hazardous metals exceeded the acceptability level established in the European Union for Pb, Cd, and Hg by 20%, 10%, and 10%, 15%, 5%, and 20%, 35%, 30%, and 45%, 25%, 25%, and 40%, in examined herring, mackerel, sardine, and tuna, respectively. In contrast, all salmon samples were accepted for Pb and Hg, and only 5% were not accepted due to a higher Cd level than the maximum permissible limit. The average estimated daily intake of (EDI) is below the tolerable daily intakes (TDIs) for all metals. Comparatively, the EDI of Hg was 0.265 μg/kg body weight (B.W) exceeded TDIs 0.228 μg/kg B.W. The hazard index for canned tuna and sardines is more than one. Conclusion: Canned fish products are contaminated with a variety of toxic metals, especially sardine and tuna. Therefore, it is advised to decrease the consumption rate of such fish products. [ABSTRACT FROM AUTHOR]

In view of multiplicity of carcinogenic pathways of gastric carcinoma (GC), poor survival and chemotherapy resistance, more analysis of these pathways is required for prediction of prognosis and developing new therapeutic targets. Knocking down of RORα; induces tumor cell proliferation and epithelial–mesenchymal transition (EMT). LAPTM4B has been suggested to be associated with EMT which promote tumor invasion. This work aimed to investigate prognostic role of RORα, LAPTM4B, and E-Cadherin expression in GC. This retrospective immunohistochemical study assesses the expression of RORα, LAPTM4B, and E-Cadherin in 73 primary gastric carcinomas. Low RORα and high LAPTM4B expression in GC cases were associated with unfavorable prognostic factors such as positive lymph nodes, and high tumor budding. E-Cadherin heterogeneous staining was associated with poor prognostic criteria, such as diffuse type GC and high tumor budding. Low RORα, high LAPTM4B, and heterogeneous E-Cadherin were the most common immunohistochemical profile in GC cases. Low RORα expression showed poor prognostic impact on overall patient survival. In conclusion, RORα and LAPTM4B may have crucial role in GC aggressiveness. The predominance of low RORα, high LAPTM4B, and heterogeneous or negative E-Cadherin immunohistochemical profile in GC cases with unfavorable pathological parameters suggested that this profile may predict tumor behavior. [ABSTRACT FROM AUTHOR]

It is a curious fact that the reverse surface of many of the so-called Amarna letters sent by Levantine rulers to the Egyptian pharaoh are completely blank or only partially inscribed. In this article, I establish the absolute and relative frequency of the phenomenon within this subcorpus of the Amarna letters. Next, I connect it to a particular type of letter sent by the Levantine rulers that I designate a "replies-to-an-order" letter and offer a suggestion as to why the Egyptian administration may have requested that these letters have blank space on the reverse surface. Finally, I consider one possible origin for the phenomenon in other cuneiform corpora and end the article with a few comments on directions for future research. [ABSTRACT FROM AUTHOR]

Objectives: The present study aimed to investigate the correlation between dental caries and its consequences in terms of pulp involvement, ulceration, fistula, abscess utilizing (PUFA/pufa) indices and specific Body Mass Index (BMI) with reference to age in a group of Egyptian Children Methods: A total of 201 children (101 female and 100 male) from Pediatric Dentistry Department in Cairo University having PUFA/pufa =1 were included. PUFA/pufa index was used according to the standard procedure to assess the consequence of untreated dental decay. The height and weight of the children were determined using standardized scales. The BMI percentile was computed using Centers for Disease Control and Prevention (CDC) growth charts. Results: The correlation between PUFA/pufa and body mass index (BMI) showed no significance correlation (P = 0.740). The correlation between PUFA/pufa scores and BMI in reference to gender also showed no significance correlation. However, the correlation between pufa and BMI percentile group showed positive correlation (P=0.405). Conclusions: The result show High prevalence of untreated dental caries between children. The younger children have positive correlation between pufa scores and BMI as compared with older children. [ABSTRACT FROM AUTHOR]

This document is an editorial from the Journal of Religion in Africa. The author expresses gratitude to the previous editor, Dr. Elias Bongmba, for his contributions to the field of religious studies and theology. The editorial also acknowledges the passing of two individuals, Marinus Chijoke Iwuchukwu and Marc Augé, who made significant contributions to the study of religion in Africa. The editorial highlights the themes of Christianization in Africa and the resiliency and creativity of religion on the continent. It discusses specific articles in the journal that explore these themes, including the religiosity of Egyptian women, the Christianization of the AmaXhosa in South Africa, the relationship between African Traditional Religion and Christianity, and the incorporation of outside influences in Islam in Nigeria. Overall, the editorial celebrates the capacity of African religions to transform and renew themselves. [Extracted from the article]