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Abstract Background ESBL-producing Enterobacteriaceae (ESBL-PE) represent a significant global health threat. In response to this growing concern and the lack of a surveillance system for ESBL-PE infections in Egypt, we conducted this meta-analysis. In this study, we aimed to quantify the prevalence of ESBL-PE based on the source of infection and characterize their molecular dissemination. Additionally, we sought to uncover temporal trends to assess the spread of ESBL-PE over time. Methods A comprehensive literature search was conducted in PubMed, Scopus, Google Scholar, Web of Science, and the Egyptian Knowledge Bank to identify studies that: (1) report the prevalence of ESBL-PE in Egypt; (2) use valid detection methods; (3) involve clinical specimens; and (4) were published between 2010 and 2024. The quality of the included studies was evaluated using the “Joanna Briggs Institute Critical Appraisal Checklist”. Meta-analysis was performed using the R meta package, reporting pooled prevalence with 95% confidence intervals (CI) via a random effects model. Results This meta-analysis included 34 studies with 4,528 isolates, spanning 2007 to 2023. The overall prevalence of ESBL-PE in Egypt was 60% (95% CI: 54–65). The leave-one-out meta-analysis demonstrated the absence of influential outliers and Egger’s test indicated no evidence of publication bias (P = 0.25). The prevalence of ESBL-PE was 62% (95% CI: 55–68) in nosocomial infections and 65% (95% CI: 52–75) in community-acquired infections, with no statistically significant difference (P = 0.68). The prevalence of ESBL producers in E. coli (64%) and K. pneumoniae (63%) is higher than in Proteus mirabilis (46%) (P = 0.06). Temporal analysis showed a stable ESBL prevalence over time. Moreover, in phenotypically confirmed ESBL-producing, E. coli harboring bla CTX−M was most prevalent (73%), followed by bla TEM (60%) and bla SHV (22%), with significant differences (P

Abstract Background Cervical cancer, though one of the most common cancers affecting women globally, holds immense potential for prevention through screening. Therefore, we conducted this meta-analysis to assess the rate of cervical cancer screening in Arab countries and identify barriers among those who did not participate. Methods A comprehensive search was conducted from January 1st to June 1st,2024, including all observational studies that reported cervical cancer screening uptake in any Arab country. A meta-analysis was performed using a random-effects model to estimate the pooled prevalence, and sensitivity analyses were conducted to test the robustness of the findings. The study followed PRISMA guidelines. Results This meta-analysis, covering 55 studies and 204,940 Arab women, found an overall cervical cancer screening uptake rate of 18.2% (95% CI: 13.9–23.6), with sensitivity analysis confirming the reliability of this estimate. Country disparities were evident, with Bahrain having the highest uptake at 44.1%, while Somalia had the lowest at 8.9%. Among women who underwent screening, the majority were ever-married (94.7%) and held positive attitudes towards screening (91.0%). Barriers to screening were common among women who did not participate, with the most frequent reasons being a lack of information (25.1%), the misconception of feeling healthy (24.5%), fear of the procedure (19.3%), and feelings of embarrassment (13.2%). Additionally, women who were screened had lower perceived barrier scores (SMD = -0.466) and higher perceived benefits scores (SMD = 0.379) than those who were not (p

Abstract Background Depression is the most common psychiatric disorder in older adults, even though it is commonly misdiagnosed and undertreated, leading to exacerbations of preexisting medical conditions and even a higher mortality rate. In the present systematic review with meta-analysis, we quantify the magnitude of depression and its associated risk factors among the older adult population in Egypt. Methods A thorough literature search was performed from 2010 up to October 2023. The results were presented as proportions or risk difference with a 95% confidence interval (CI) calculated using the random effects model. A sensitivity analysis was performed to examine the robustness of the results. Results Our study included 14 articles with 5857 older adults published between 2011 and 2023. All the included studies assessed depression in geriatrics using the Geriatric Depression Scale. Of the 14 studies, 5 were for community-dwelling older adults, 3 were for older adults attending primary health care (PHC) centers, 2 were for hospitalized older adults, 3 were for residing in geriatric homes, and one for residing in geriatric homes, hospitalized older adults, and community-dwelling older adults. The overall prevalence of depression among Egyptian geriatrics was 64.6%. The pooled prevalence of depression was 59.6%, 67.0%, 67.0%, and 62.0% for community-dwelling older adults, older adults people attending PHC, hospitalized older adults, and older adults residing in geriatric homes, respectively. Older adults with chronic illness, female sex, and low-income elders and elders who were not employed had a higher risk for depression with pooled risk differences of 34.9%, 17.8%, 23.8%, and 15.1% (P

Abstract Background Limited data is available regarding the severity and mortality of Mpox in individuals with immunocompromised conditions. Therefore, we performed this meta-analysis to understand the impact of HIV- or non-HIV-associated immunosuppression on the severity of Mpox requiring hospitalization and mortality. Methods A thorough literature search was performed from 2022 up to January 2024. The results were presented as odds ratios (ORs). We only included patients who required hospitalization for severity rather than isolation. Results A total of 34 studies were included in this analysis. Our analysis did not find a significant difference in the hospitalization risk between HIV-positive individuals and those who were HIV-negative (OR = 1.03; P = 0.85; 7 studies; CD4 count of fewer than 200 cells/µL was less than 0.5% across all studies). Patients with a CD4 count lower than 200 cells/µL or an unsuppressed RNA viral load (> 200 copies/ml) had a significantly higher hospitalization risk (OR = 5.3, P

Abstract Background Previous meta-analyses estimating the prevalence of the post-COVID-19 condition (PCC) were confounded by the lack of negative control groups. This may result in an overestimation of the prevalence of those experiencing PCC, as these symptoms are non-specific and common in the general population. In this study, we aimed to compare the burden of persistent symptoms among COVID-19 survivors relative to COVID-19-negative controls. Methods A systematic literature search was conducted using the following databases (PubMed, Web of Science, and Scopus) until July 2023 for comparative studies that examined the prevalence of persistent symptoms in COVID-19 survivors. Given that many of the symptoms among COVID-19 survivors overlap with post-hospitalization syndrome and post-intensive care syndrome, we included studies that compare the prevalence of persistent symptoms in hospitalized COVID-19 patients relative to non-COVID-19 hospitalized patients and in non-hospitalized COVID-19 patients relative to healthy controls that reported outcomes after at least 3 months since infection. The results of the meta-analysis were reported as odds ratios with a 95% confidence interval based on the random effects model. Results Twenty articles were included in this study. Our analysis of symptomatology in non-hospitalized COVID-19 patients compared to negative controls revealed that the majority of symptoms examined were not related to COVID-19 infection and appeared equally prevalent in both cohorts. However, non-COVID-19 hospitalized patients had higher odds of occurrence of certain symptoms like anosmia, ageusia, fatigue, dyspnea, and brain fog (P

Abstract Background Post-COVID-19 survivors may experience long-term symptoms known as Post-acute COVID-19 syndrome (PACS). The PCAS symptom spectrum includes a wide range of symptoms affecting different organs. The prevalence and risk factors of PACS may vary across different regions, and a meta-analysis focused on Egypt can help understand the national prevalence and unique population-specific predictors. Methods A comprehensive literature search was conducted following the PRISMA guidelines to identify studies published in Egypt that documented symptoms, signs, and post-COVID-19 outcomes in patient cohorts. The results were reported, based on the random effects model, as proportions (%) and odds ratios with 95% CI. Results A total of 16 studies with 3097 COVID-19 survivors and an age range of 3 to 94 years were included in the analysis. The pooled prevalence of COVID-19 survivors experiencing at least one persistent symptom, regardless of hospitalization status, was high at 78.3%. A total of 54 clinical symptoms or conditions were reported among the survivors. The most commonly reported symptom was fatigue, which affected approximately half of all survivors (48.1%). Bone ache or myalgia, anorexia, anxiety, dyspnea, and depression were also among the most frequently reported symptoms at 32.9%, 32.8, 31.5, 19.9, and 19.5, respectively. The pooled prevalence of Post-COVID-19 pulmonary fibrosis (PCPF) among hospitalized Covid survivors was 40%. The study found that female sex, severe COVID, and the presence of any comorbidity were independent risk factors for PACS (P

Abstract Background Occult hepatitis B virus (HBV) infection (OBI) is a major public health problem. The clinical importance of OBI stems from the fact that it can be transmitted to healthy individuals at extremely low viral load levels. Additionally, immunosuppression has the potential to trigger viral replication, which can result in life-threatening liver decompensation. Despite several studies examining the prevalence of OBI, the pooled prevalence of OBI in Egypt remains unknown, particularly among blood donors and high-risk individuals, to whom intervention should be targeted. Methods A comprehensive literature search of the following databases was conducted from inception to October 2022 using the following keywords: occult hepatitis B virus infection or occult HBV infection or OBI and Egypt in MEDLINE [PubMed], Scopus, Google Scholar, and Web of Science. The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. I-squared and Cochran’s Q were used to measure the heterogeneity between the studies, and based on the random effects model, results were reported as proportions (%) with a 95% confidence interval (CI). Analyses of subgroup analyses were conducted based on the target population. Sensitivity analyses were conducted using the leave-one-out approach to test the robustness of the results. Results A total of 50 studies with 62 estimations of OBI were included, 19 in patients who were HBsAg-negative and anti-HBc-positive and 43 in patients who were HBsAg-negative. The highest prevalence (41%) was among multi-transfused patients according to studies that report occult hepatitis B virus prevalence in an HBsAg-negative population, while the pooled prevalence of OBI among patients on hemodialysis, patients with chronic hepatitis C infection, patients with hepatocellular carcinoma (HCC), and patients with liver cirrhosis was 17%, 10%, 24%, and 13%, respectively. On the other hand, among studies that report OBI prevalence in HBsAg-negative and anti-HBc-positive individuals, the pooled prevalence of OBI among blood donors, patients with chronic hepatitis C infection, and patients with HCC was 12%, 15%, and 31%, respectively. Also, the majority of studies examining the genetic background of OBI have found that genotype D is the most prevalent. Conclusion This study highlights the high prevalence in OBI among blood donors and high-risk populations in Egypt. The implementation of HBV nucleic acid amplification testing (NAT) may increase the safety of blood transfusions by excluding all HBV DNA-positive donations. However, the cost-effectiveness of these tests should be investigated.

Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen that causes severe morbidity and mortality worldwide. For the establishment of national strategies to combat MRSA infection in each country, accurate and current statistics characterizing the epidemiology of MRSA are essential. The purpose of this study was to determine the prevalence of MRSA among Staphylococcus aureus clinical isolates in Egypt. In addition, we aimed to compare different diagnostic methods for MRSA and determine the pooled resistance rate of linezolid and vancomycin to MRSA. To address this knowledge gap, we conducted a systematic review with meta-analysis. Methods A comprehensive literature search from inception to October 2022 of the following databases was performed: MEDLINE [PubMed], Scopus, Google Scholar, and Web of Science. The review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Statement. Based on the random effects model, results were reported as proportions with a 95% confidence interval (CI). Analyses of the subgroups were conducted. A sensitivity analysis was conducted to test the robustness of the results. Results A total of sixty-four (64) studies were included in the present meta-analysis, with a total sample size of 7171 subjects. The overall prevalence of MRSA was 63% [95% CI: 55–70]. Fifteen (15) studies used both PCR and cefoxitin disc diffusion for MRSA detection, with a pooled prevalence rate of 67% [95% CI: 54–79] and 67% [95% CI: 55–80], respectively. While nine (9) studies used both PCR and Oxacillin disc diffusion for MRSA detection, the pooled prevalences were 60% [95% CI: 45–75] and 64% [95% CI: 43–84], respectively. Furthermore, MRSA appeared to be less resistant to linezolid than vancomycin, with a pooled resistance rate of 5% [95% CI: 2–8] to linezolid and 9% [95% CI: 6–12] to vancomycin, respectively. Conclusion Our review highlights Egypt's high MRSA prevalence. The cefoxitin disc diffusion test results were found to be consistent with PCR identification of the mecA gene. A prohibition on antibiotic self-medication and efforts to educate healthcare workers and patients about the proper use of antimicrobials may be required to prevent further increases.

Abstract Background Vancomycin-resistant Enterococci (VRE) represent a critical medical and public health concerns due to their association with serious nosocomial infections and a high risk of mortality. We aimed to reveal the pooled prevalence of VRE and antimicrobial resistance profiles among enterococci clinical isolates in Egypt. Methods A PubMed, Scopus, Google Scholar, and Web of Science literature search was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Only published studies documenting the prevalence of VRE between 2010 and 2022 were included. Using the random effects model and the 95% confidence intervals, the pooled estimate of VRE was calculated by MedCalc Version 20.113. Cochran’s Q and I 2 tests were used to evaluate the degree of heterogeneity, and publication bias was examined by visually examining the funnel plot and its associated tests (Begg’s and Egger’s tests). Results The pooled prevalence of VRE among enterococci clinical isolates in Egypt was estimated to be 26% (95% CI 16.9 to 36.3). E. faecalis had a greater pooled prevalence than E. faecium, with 61.22% (95% CI 53.65 to 68.53) and 32.47% (95% CI 27 to 38.2), respectively. The VanA gene is more frequent than the VanB gene among VRE, with a pooled prevalence of 63.3% (95% CI 52.1 to 73.7) and 17.95% (95% CI 7.8 to 31), respectively. The pooled resistance rate of linezolid was substantially lower than that of ampicillin and high-level gentamicin (HLG) 5.54% (95% CI 2.33 to 10%), 65.7% (95% CI 50.8 to 79.2%), and 61.1% (95% CI 47.4 to 73.9), respectively. Conclusion The prevalence of VRE is alarmingly high in Egypt. It is imperative that antimicrobial stewardship activities and infection control programs are strictly adhered to and implemented to prevent further escalation of the problem.

Abstract Background A urachal cyst has a rare incidence that has been reported as 1/5,000 live birth. Case presentation We report two patients with a complicated urachal cyst, a 5-year-old female who presented to the emergency department with severe abdominal pain and a 3-year-old female presenting with abdominal pain and constipation. Upon laparoscopic exploration both patients had complicated urachal cysts which were adherent to the urinary bladder. Conclusion Complicated urachal cysts can present with acute abdominal pain.

Abstract Background Hepatitis B infection seriously threatens global public health, especially in developing nations. Despite several investigations on HBV incidence, the national pooled prevalence remains unknown, particularly in populations at-risk at whom interventions should be primarily aimed. Methods A comprehensive literature search of the following databases: Medline [PubMed], Scopus, Google Scholar, and Web of Science was conducted following the PRISMA guidelines. I-squared and Cochran's Q were used to measure the heterogeneity between the studies. Publications that matched the following were included: Primary studies published in Egypt from 2000 to 2022 reported HBV prevalence based on HBsAg. We excluded any studies that were not performed on Egyptians or that were performed on patients suspected of acute viral hepatitis or studies focusing on occult hepatitis or vaccination evaluation studies, or national surveys. Results The systematic review included 68 eligible studies reporting a total of 82 incidences of HBV infection based on hepatitis B surface antigen with a total sample size of 862,037. The pooled national prevalence among studies was estimated to be 3.67% [95% CI; 3: 4.39]. Children under 20 with a history of HBV vaccination during infancy had the lowest prevalence of 0.69%. The pooled prevalence of HBV infection among pregnant women, blood donors, and healthcare workers was 2.95%, 1.8%, and 1.1%, respectively. While patients with hemolytic anemia and hemodialysis patients, patients with malignancies, HCC patients, and chronic liver disease patients had the highest prevalences at 6.34%, 25.5%, 18.6%, and 34%, respectively. Studies reporting HBV prevalence in urban settings compared to rural settings revealed a similar HBV prevalence of 2.43% and 2.15%, respectively. Studies comparing HBV prevalence in males and females revealed a higher prevalence among males (3.75%) than females (2.2%). Conclusion In Egypt, hepatitis B infection is a significant public health issue. The blocking of mother-to-infant hepatitis B transmission, the scaling up of the scope of the existing vaccination program, and implementing new strategies, including screen-and-treat, may reduce the prevalence of the disease.

Fiber-reinforced cementitious composites (FRCC) are one of the leading engineering materials in the 21st century, as they offer proficiency in enhancing strength, ductility, and durability in structural engineering applications. Because the recently developed basalt fiber pellets (BFP) offer combined strands of fibers encased in a polymer matrix, they are being prevalently studied to explore new possibilities when used in brittle materials such as mortar and concrete. Hence, this paper synthesizes the intensive research efforts and contributions to this novel class of fibers conducted by the authors. Specifically, it reviews the fresh, mechanical, and durability properties of FRCC incorporating single BFP or hybrid with polyvinyl alcohol fibers and modified with slag/fly ash and nano-materials and its suitability for different field applications. In addition, the nano- and meso-scale modeling of such matrices are described. BFP significantly contributes to improving post-cracking flexural behavior by toughening the cementitious matrix and minimizing strength losses when exposed to harsh environments. All results show promising progress in the development of high-performance FRCC comprising BFP, with potential success for structural and pavement applications.

Background: Rheumatoid arthritis (RA) is a chronic and systemic autoimmune disease that is characterized by severe synovial inflammation, cartilage erosion, bone loss, and generalized vasculopathy. Although the immunologic mechanism of RA is still unclear, it is now thought to be a primarily Th17-driven disease. Along with other factors, IL-23 stimulates the expansion of Th17 cells from naive CD4+ T cells. Objective: The objective of this study is to assess the circulating levels of interleukin (IL)-23 in rheumatoid arthritis (RA) and determine the correlation between plasma/serum IL-23 levels and disease activity. So, we performed a systematic review with meta-analysis comparing plasma/serum IL-23 levels between patients with RA and controls and examined correlation coefficients between circulating IL-23 levels and disease activity Subjects and Methods: Using the following keywords: lenterleukin-23, IL-23, and rheumatoid arthritis, a comprehensive literature search was carried out in the following databases: PubMed, Scopus, Google Scholar, and Web of Science. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards were followed, and the review was registered in the PROSPERO International prospective register of systematic reviews with registration number CRD42022345901. Results were reported as standardized mean differences (SMDs) with a 95% confidence interval. All statistical analysis was performed using StatsDirect statistical software version 3.0.0 (StatsDirect Ltd., Cheshire, UK). A sensitivity analysis was conducted using the leave-one-out approach to test the robustness of the results. Results: The total sample size for the RA group included in our review was 408 cases, while the control group sample size was 244 cases. The serum IL-23 level in the RA group was significantly higher than the control group (pooled SMD = 3.5, 95% CI; 2.1: 4.8, P < 0.0001) as compared to the control group. There were 8 studies with a total sample size of 402 that reported the correlation between IL-23 and DAS28-based RA activity. According to our findings, a significantly positive correlation between IL-23 and DAS28-based RA activity was found, with a weighted mean correlation of 0.57 (95% CI; 0.4: 0.75, P < 0.0001). Conclusion: Our meta-analysis has shown that IL-23 circulatory levels are higher in RA patients and that there is a significant positive correlation between IL-23 and disease activity. Our findings emphasize the role that IL-23 may have in RA. More studies may be required to fully comprehend the involvement of IL-23 in RA.

Introduction: Foreign body ingestion is commonly seen in paediatrics. Magnets, button batteries and sharp objects can cause life threatening complications. Intestinal obstruction, peritonitis and fistula formation between bowel loops are reported complications to multiple magnets ingestion. Case presentation: We report a case of a 5-year-old who swallowed 52 toy magnets. He presented with peritonitic abdomen which required abdominal exploration, resection of necrotic bowel segments and 6 bowel anastomosis. The postoperative course was uneventful. Discussion: The earliest report of multiple magnets ingestion was reported from Japan in 1995, which was complicated by bowel perforation. If the magnetic foreign bodies remain in a fixed position on repeated abdominal x-rays, surgical treatment should be considered even if the patient is asymptomatic, because, in such patients, entero-enteric intestinal fistulas are likely to have formed. Conclusion: The ingestion of multiple magnets can lead to life-threatening complications in children. One must have a low threshold for performing diagnostic imaging in children presenting with vague abdominal symptoms if there is a history of potentially ingesting a foreign body, even if unwitnessed.

The biomedical materials that have been used in the structure of heart pumps are classified as biocompatible, and these can be metals, polymers, ceramics, and composites. Their positions in the pump vary according to the part’s function. Whereas various materials have different properties, all biomaterials chosen for cardiovascular applications should have excellent blood biocompatibility to reduce the likelihood of hemolysis and thrombosis. There are two major categories of the heart pumps; pulsatile and rotary blood pumps (axial and centrifugal) and the features of some of these materials allow them to be used in both. Rotary and pulsatile blood pump devices have to be fabricated from materials that do not result in adverse biological responses. The purpose of this review is to study the available biocompatible materials for the pulsatile and rotary blood pumps as clinically-approved materials and prototype heart pump materials. The current state of bio-compatible materials of rotary and pulsatile blood pump construction is presented. Some recent applications of surface amendment technology on the materials for heart assist devices were also reviewed for better understanding. The limitations of heart assist devices, and the future direction of artificial heart elements have been considered. This review will be considered as a comprehensive reference to rapidly understanding the necessary research in the field of biocompatible materials of pulsatile and blood rotary pumps.

Peptic ulcer is a relatively uncommon disease in children, compared to adults, with an incidence of 2–8%. Although well-established in adults' sector, the management of perforate peptic ulcer is still challenging in pediatric population. we reported two cases, two- and five-years old males, who presented with peritonitis following perforation of duodenal ulcer and managed with Graham's patch laparoscopically. The postoperative period of the two cases was uneventful and the cases were discharged on the 8th postoperative day. We found that laparoscopic omental repair was safe and effective among children with perforated peptic ulcer.

Introduction: Perforated peptic ulcer remains one of the critical abdominal conditions that requires early surgical intervention. Leakage after omental patch repair represents one of the devastating complications that increase morbidity and mortality. Our study aimed to assess risk factors and early predictors for incidence of leakage. Methods: Retrospective analysis of data of the patients who underwent omental patch repair for perforated peptic ulcer in the period between January 2019 and January 2022 in Mansoura University Hospital, Egypt. Pre, intra and postoperative variables were collected and statistically analyzed. Incriminated risk factors for leakage incidence were analyzed using univariate and multivariate analysis. Results: This study included 123 patients who met inclusion criteria. Leakage was detected in seven (5.7%) patients. Although associated comorbidities (p=0.01), postoperative intensive care unit admission (p=0.03), and postoperative hypotension (p=0.02) were significant risk factors in univariate analysis, septic shock (p=0.001), delayed intervention (p=0.04), preoperative hypoalbuminemia (p=0.017), and perforation size >5mm (p= 0.04) were found as independent risk factors for leakage upon multivariate analysis. Conclusion: Delayed presentation in septic shock, preoperative hypoalbuminemia, prolonged perforation, operation interval, and large perforation size > 5mm were detected as independent risk factors for leakage. Postoperative tachypnea and tachycardia with increased levels of C-reactive protein and total leucocytic count are alarming signs for incidence of leakage. [ABSTRACT FROM AUTHOR]

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Composite sandwich structures have been used in high performance applications such as wind turbine blades, due to their unique lightweight structure and superior mechanical properties. In the current study, a new liquid thermoplastic and thermoset resin were used to fabricate four different composite sandwich panels with two various foam types and densities. Composites made with epoxy resin are presented to comprehensively compare the mechanical properties of sandwich structures to elium resin. In the case of the mechanical properties and due to a new liquid thermoplastic resin, extensive comparisons of three-point bending, climbing drum peel, and flatwise tensile strength were investigated and compared with each other. The flexural and flatwise strength of sandwich composite increased by 53% and 75%, respectively, when using Elium resin. Then, the highest value was shown in the GF/PVC/ELIUM structure. The results revealed that Elium resin could be excellent in the case of mechanical properties to replace traditional resins to fabricate various composite structures and manage the challenge of recyclable composites. Elium resin can replace thermoset-based resins for the manufacturing of laminates and composites that are fully recyclable at room temperature with comparable mechanical properties. [ABSTRACT FROM AUTHOR]