Colonoscopy screening for colorectal cancer in Egypt: a nationwide cross-sectional study.

BACKGROUND: Current guidelines advocate for colorectal cancer (CRC) screening in adults who are at risk by using direct visualization methods such as colonoscopy. However, in Egypt, there is a paucity of data regarding the current practice of colonoscopy screening. Moreover, more information is needed about the knowledge and attitudes of potential participants regarding the procedure and possible barriers that can limit their participation. METHODS: We conducted a nationwide cross-sectional study using an interview-based survey of patients aged 45 years or above who presented to outpatient clinics of nine university hospitals throughout Egypt. Participants were surveyed to assess their compliance with CRC colonoscopy screening guidelines, their knowledge of and attitude towards colonoscopy screening, and their perspective on potential barriers to colonoscopy screening. RESULTS: A total of 1,453 participants responded to our survey in the nine study centers. Only a minority of participants (2.3%) were referred for CRC screening. Referral rates were higher among those who knew someone with a history of CRC (5.3% vs 1.5%, p < 0.001) or had a discussion with their physician about CRC (25.8% vs 0.7%, p < 0.001). Few responders (3.2%) had good knowledge regarding CRC screening. After introducing the concept of CRC screening to all participants, most patients (66.7%) showed a positive attitude towards having the procedure. Financial burden and fear of results were the two most frequently cited barriers to undergoing CRC screening (81.1%; and 60.1%, respecteively). CONCLUSIONS: Despite the positive attitude, there is insufficient knowledge about CRC screening among eligible participants in Egypt. This has probably contributed to low compliance with current CRC screening guidelines and needs to be addressed at the national level.

Knowledge, attitude, and perception of Arab medical students towards artificial intelligence in medicine and radiology: A multi-national cross-sectional study.

OBJECTIVES: We aimed to assess undergraduate medical students' knowledge, attitude, and perception regarding artificial intelligence (AI) in medicine. METHODS: A multi-national, multi-center cross-sectional study was conducted from March to April 2022, targeting undergraduate medical students in nine Arab countries. The study utilized a web-based questionnaire, with data collection carried out with the help of national leaders and local collaborators. Logistic regression analysis was performed to identify predictors of knowledge, attitude, and perception among the participants. Additionally, cluster analysis was employed to identify shared patterns within their responses. RESULTS: Of the 4492 students surveyed, 92.4% had not received formal AI training. Regarding AI and deep learning (DL), 87.1% exhibited a low level of knowledge. Most students (84.9%) believed AI would revolutionize medicine and radiology, with 48.9% agreeing that it could reduce the need for radiologists. Students with high/moderate AI knowledge and training had higher odds of agreeing to endorse AI replacing radiologists, reducing their numbers, and being less likely to consider radiology as a career compared to those with low knowledge/no AI training. Additionally, the majority agreed that AI would aid in the automated detection and diagnosis of pathologies. CONCLUSIONS: Arab medical students exhibit a notable deficit in their knowledge and training pertaining to AI. Despite this, they hold a positive perception of AI implementation in medicine and radiology, demonstrating a clear understanding of its significance for the healthcare system and medical curriculum. CLINICAL RELEVANCE STATEMENT: This study highlights the need for widespread education and training in artificial intelligence for Arab medical students, indicating its significance for healthcare systems and medical curricula. KEY POINTS: • Arab medical students demonstrate a significant knowledge and training gap when it comes to using AI in the fields of medicine and radiology. • Arab medical students recognize the importance of integrating AI into the medical curriculum. Students with a deeper understanding of AI were more likely to agree that all medical students should receive AI education. However, those with previous AI training were less supportive of this idea. • Students with moderate/high AI knowledge and training displayed increased odds of agreeing that AI has the potential to replace radiologists, reduce the demand for their services, and were less inclined to pursue a career in radiology, when compared to students with low knowledge/no AI training.

Effect of Omega-3 fatty acids supplementation on serum level of C-reactive protein in patients with COVID-19: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Omega-3 may alleviate the severity of coronavirus disease 2019 (COVID-19) by reducing the C-reactive protein (CRP) level, a marker for systemic inflammation. Because the scientific evidence indicating such a role is inconsistent, we aimed to evaluate the effect of Omega-3 on CRP change and CRP level in patients with COVID-19. METHODS: We conducted a comprehensive search on four databases (PubMed, Web of Science, EMBASE, and Scopus). We included all RCTs comparing Omega-3 with a control group regarding their effect on the CRP levels in patients with COVID-19. We used version two of the Cochrane risk of bias assessment tool to appraise the included studies. We extracted data to an online data extraction sheet. The primary outcomes were CRP change from baseline and CRP serum levels. RESULTS: We included four randomized controlled trials (RCTs) with 274 patients in this study. The overall effect estimate favored Omega-3 over the control group in terms of CRP change from baseline (mean difference (MD) =- 2.53, 95% confidence interval (CI): - 4.40, - 0.66) and CRP serum levels at the end of the study (MD =- 6.24, 95% CI: - 11.93, - 0.54). CONCLUSION: Omega-3 showed promising effects on systemic inflammation by reducing CRP levels in COVID-19 patients. Based on this finding, we recommend Omega-3 for COVID-19 patients for its anti-inflammatory actions.

Safety and efficacy of adipose-derived mesenchymal stem cells for knee osteoarthritis: A systematic review and m-analysis.

OBJECTIVE: This research aimed to study the safety and efficacy of adipose-derived mesenchymal stem cells (ADMSCs) for knee osteoarthritis (OA). METHODS: We used six databases to search for records and then screened them for eligibility. In both randomized and non-randomized studies, the risk of bias was assessed. The data were then retrieved and used in single-arm and double-arm analyses using Comprehensive Meta-Analysis (CMA) Version 3.0 and RevMan Version 5.3, respectively. RESULTS: Based on the study's inclusion criteria, we included 15 studies with a total of 463 patients. According to our single-arm analyses, there was a significant improvement in quality of life (QOL) among the three dose subgroups (high, medium, and low doses), as measured by SF-36 scores after a year of follow-up [low dose: mean (M)=-23.99; 95% confidence interval (CI) [-31.49 to -16.49]; P<0.001; medium dose: M=-15.96; 95% CI [-23.5 to-8.42]; P<0.001; high dose: M=-19.31; 95% CI [-28.02 to -10.59], P<0.001] and the knee injury and osteoarthritis outcome score (KOOS) QOL sub-score after six months following ADMSCs injection in the low-dose group (M=24.9; 95% CI [4.3 to 45.6]; P<0.05). Moreover, after three months of follow-up, we detected significant pain reduction as measured by the numeric pain rating scale (NPRS), with no significant difference between the low and medium doses (low dose: M=-3.12; 95% CI [-5.09 to -1.14]; P<0.01; medium dose; M=-2.17; 95% CI [-3.13 to -1.21]; P<0.001). However, after a year, the results were no longer significant. Despite finding no significant difference between them after 6 and 12 months post-treatment in the Visual Analogue scale (VAS) scale and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score, double-arm analyses revealed significant pain reduction in the ADMSCs group over the control after 12 months as estimated by the WOMAC pain sub-score (mean difference (MD)=-1.85, 95% CI [-3.55, -0.15], P<0.05). After six months, the low dosage group's knee functions and activity levels improved significantly, as determined by the WOMAC physical function and stiffness subscales (M=-23.79; 95% CI [-38.43 to -9.16]; P=0.001; M=-10.25; 95% CI [-17.31 to -2.59]; P<0.01, respectively), as well as the KOOS scores after a year (P<0.01 for all KOOS subscales). In the ADMSCs injections group, there were no serious adverse effects [event rate (ER)=0.11; 95% CI [0.03-0.3]; P=0.001]. CONCLUSION: In the present single-arm meta-analysis, ADMSCs were associated with significant reduction in pain and improvement in QOL and knee functions in patients with knee OA. However, double arm analyses did not confirm these positive findings, which may be returned to the small sample size of included patients. Therefore, to introduce ADMSCs into clinical practice and establish guidelines for their use, more randomized controlled clinical trials with large sample sizes and long-term follow-ups are needed.