Monkeypox virus infection and myocarditis: A review of current evidence and possible pathogenesis.

The recent spread of the monkeypox virus (MPXV), causing monkeypox (mpox), to non-endemic areas, and the atypical and unusual clinical manifestations observed during its 2022 outbreak has focused international interest on the clinical features of the disease. Mpox is usually a self-limiting disease with mild symptoms with common manifestations, including fever and skin lesions; however, severe manifestations could occur in some vulnerable groups (children and those with impaired immune systems) and may present multisystem complications and fatal outcomes. In most cases, a fever is the first sign of disease, followed by the development of various inflammatory lesions on the skin, such as vesiculopustular rashes and ulcers. Pneumonitis, encephalitis, keratitis, secondary bacterial infections, acute kidney injury, and myocarditis are all possible outcomes of the infection. Myocarditis has been reported to be caused by orthopoxviruses, and it is a serious condition of which its pathophysiology is little understood. Recent reports have indicated myocarditis with cardiac involvement as a possible atypical and unusual consequence of the MPXV infection during present outbreak. This review provides an overview of the clinical manifestations of mpox with a special focus on its effects on the heart, including myocarditis. The evidence of the myocarditis in mpox patients and its possible pathogenesis are discussed.

Evaluation of medical waste incinerators in Alexandria.

Medical establishments play important roles in different activities by using of modern technology to serve the humans and the environment through different departments in the establishment and its firms. Medical wastes are considered as a hazardous waste because they contain toxic materials, infectious, or non-infectious wastes and they are considered as a hazard to millions of patients, health care workers, and visitors. Treatment processes for medical wastes comprise autoclaving, microwaving, chemical disinfection, irradiation, plasma system, and incineration. Incineration is a thermal process, which destroys most of the waste including microorganisms. Combustion process must be under controlled conditions to convert wastes containing hazardous materials into mineral residues and gases. Hospital waste incinerators may emit a number of pollutants depending on the waste being incinerated. These pollutants include particulate matter, acid gases, toxic metals, and toxic organic compounds products of incomplete combustion, e.g., dioxins, furans, and carbon monoxide, as well as sulfur oxides and nitrogen oxides. So, there should be a reduction of emissions of most of these pollutants by air pollution control devices. This study was conducted in 51 medical establishments (ME) in Alexandria. To evaluate its incinerators. It was found that only 31.4% of total ME have their own incinerators to treat their medical waste. Also, the incinerators conditions were poor with incomplete combustion. So, the study recommend handling of all medical wastes of ME in Alexandria by the company which is responsible now for management of domestic solid wastes of the city.

Assessment of combustion products of medical waste incinerators in Alexandria.

The emissions and ashes from medical waste incinerators might perform a threat to the environment and the public health. The aim of the present work is to evaluate the emissions and ashes of six medical wastes incinerators in six hospitals in Alexandria. Five air pollutants were sampled and analyzed in the emissions comprising smoke, lead, carbon monoxide, sulphur dioxide and nitrogen dioxide . Ash samples were analyzed for bacterial count, volatile substances, lead and cadmium. Shape and color of ash were observed visually. The results of the present study have revealed that all the average values of gases in the six incinerators were within the limits stated in Egyptian environmental law, where as carbonaceous particulate (smoke) averages of the six incinerators have exceeded the maximum allowable limit in the law. On the other hand, lead concentration in emissions were far below the maximum allowable limit in the law. Incinerator No 6 emissions have been significantly higher in CO, NO2, SO2 and smoke concentration than the other five incinerators P<0.001, P<0.0006, P<0.0001, and P<0.002 respectively. There was no significant variation in bacterial count of ash samples at 20 degrees C and 37 degrees C between the six studied incinerators. Volatile substance percentage of ash samples in the six incinerators were much higher than the recommended percentage. There was a highly significant variation between the six incinerators (p<0.005). Lead and cadmium concentrations in ash samples were much higher than those in developed countries, meanwhile, more or less as those in developing countries. It is recommended to state specific realistic emissions limits for medical waste incinerators and to substitute sporadic incinerators in hospitals by two central incinerators in proper places outside the city.

Environmental compliance of some industries in Alexandria.

Industrial development plays an important role in the national economic and socio - economic growth, in Alexandria governorate, the second largest industrial zone in Egypt. Industrialization in the past has created a measurable environmental negative impact emanating from the used technologies when the environmental dimension was not proper integrated at all stages of planning, operation or emissions pollution control. As a result a wide myriad of pollutants have reached the environment causing economic loss to the pollution process as well as an unacceptable working environmental conditions. In addition Egypt is curerently one of the Euromediterranean countries who will be an active member of the free trade zone between the Mediterranean sea north and south counrtries. The Egyptian industries have to comply with the national environmental laws as mandate for them to export or import from other countries in the region. As well the products has to be processed with cleaner technologies where all types of.