Effect of a health education program about COVID-19 on the knowledge, attitude, and practices of paramedical students in Egypt: an interventional study.

Background: In December 2019, an outbreak of novel coronavirus disease 2019, caused by severe acute respiratory syndrome coronavirus 2, has been reported in China. Objective: This study aims to assess the knowledge, attitude, and practices (KAP) of Benha Health Technical Institute (BHTI) students and to evaluate the impact of a health education program about COVID-19 on their KAP. Methods: This is an interventional study that recruited 398 students from BHTI and was conducted in 3 phases. Firstly, an assessment of students' KAP was done using a structured questionnaire concerning COVID-19. Secondly, an education program about COVID-19 was conducted. Lastly, the reassessment of KAP was carried out using the same questionnaire after one month. Results: The median knowledge, attitude, and practice scores among the studied students in the pre-interventional stage were 12, 15, and 26 which had significantly increased to 15, 16, and 28 respectively after the intervention. The knowledge score of the participants was significantly affected by students' age and grade of education; the attitude score was affected by age, gender, and grade of education, while the practice score was only affected by participants' age. Conclusion: The educational program significantly increased the KAP of BHTI students.

Evaluation of mono and combined nitrofurantoin therapy for toxoplasmosis in vivo using murine model.

Toxoplasmosis is a frequent disease with an estimated prevalence of more than one billion human cases worldwide and over one million new infections each year. It is classified as a neglected tropical disease by the CDC since 2019. The disease may pass unnoticed in healthy individuals but could be fatal in the immunocompromised. Moreover, no effective treatment is available against the chronic form of the disease. Available anti-Toxoplasma drugs are associated with many side effects. Therefore, search for new more reliable, more efficient, and less toxic therapeutic agents is a continuous endeavor. This study assesses the potential use of nitrofurantoin, a compound with well-established antimicrobial properties, as a potential anti-Toxoplasma drug in vivo. It compares its efficacy to the commonly used anti-Toxoplasma agent spiramycin by molecular and histopathological methods in acute and chronic infection. The results demonstrate a significant ability to eliminate the parasite (P < 0.001) whether used as mono- or combined therapy with spiramycin in the acute and chronic stages. When compared to the anti-Toxoplasma drug spiramycin, nitrofurantoin achieved similar efficacy in the acute and chronic infection (P = 0.65 and P = 0.096, respectively). However, better results were obtained when using a combination of both drugs (P < 0.001). Additionally, nitrofurantoin showed good inhibitory effects on the inflammatory process in the liver, kidney, and uterus of the experimentally infected animals. In conclusion, nitrofurantoin can be considered as a potential anti-Toxoplasma agent. Nevertheless, further studies are recommended before consideration for clinical trials.

The Impact of Comorbidities on the Outcomes of Egyptian COVID-19 Patients: A Follow-Up Study.

Objectives: This study evaluated the clinical manifestation of COVID-19 and adverse outcomes in patients with comorbidities (outcome: death). Methods: A comparative follow-up investigation involving 148 confirmed cases of COVID-19 was performed for a month (between April and May 2020) at Qaha Hospital to describe the clinical characteristics and outcomes resulting from comorbidities. Participants were divided into two clusters based on the presence of comorbidities. Group I comprised cases with comorbidities, and Group II included subjects without comorbidity. Survival distributions were outlined for the group with comorbidities after the follow-up period. Results: Fever (74.3%), headache (78.4%), cough (78.4%), sore throat (78.4%), fatigue (78.4%), and shortness of breath (86.5%) were the most prevalent symptoms observed in COVID-19 patients with comorbidities. Such patients also suffered from acute respiratory distress syndrome (37.8%) and pneumonia three times more than patients without comorbidities. The survival distributions were statistically significant (chi-square = 26.06, p ≤ 0.001). Conclusion: Multiple comorbidities in COVID-19 patients are linked to severe clinical symptoms, disease complications, and critical disease progression. The presence of one or more comorbidities worsened the survival rate of patients.

Corticosteroid nasal spray for recovery of smell sensation in COVID-19 patients: A randomized controlled trial.

OBJECTIVES: To evaluate the role of the topical corticosteroid, mometasone furoate, nasal spray in the treatment of post COVID-19 anosmia. METHODS: A prospective, randomized, controlled trial was conducted among patients with post COVID-19 anosmia. One hundred patients were randomly assigned to two groups; group I included 50 patients received mometasone furoate nasal spray in an appropriate dose of 2 puff (100 µg) once daily in each nostril for 3 weeks with olfactory training, group II included 50 patients were advised to keep on olfactory training only. The assessment of smell was done using (Visual Analog Scale from 0 to 10). All patients were initially evaluated after their recovery from COVID-19 and followed up for 3 weeks. The smell scores were recorded weekly and the duration of smell loss was recorded from the onset of anosmia till the full recovery. RESULTS: In both groups, the smell scores significantly improved by the end of the third week (P < 0.001). By comparing smell scores between both groups after 1 week, 2 weeks, and 3 weeks of treatment, there were no statistically significant differences between both groups. In group I, (62%) of patients completely recovered their sense of smell after 3 weeks of treatment, compared to (52%) of patients in group II (P = 0.31). CONCLUSION: The results suggested that using mometasone furoate nasal spray as a topical corticosteroid in the treatment of post COVID-19 anosmia offers no superiority benefits over the olfactory training, regarding smell scores, duration of anosmia, and recovery rates. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT04484493.

Assessment of Postpartum Depression and Anxiety among Females Attending Primary Health Care Facilities in Qaliubeya Governorate, Egypt.

Postpartum depression (PPD) is a mood disorder that begins after childbirth and usually lasts beyond six weeks; depression is often comorbid with anxiety. The main objectives of this work were to measure the prevalence of postpartum depression and/or anxiety among females in the Qaliubeya governorate to explore the underlying factors of these disorders and find if progesterone level has a role. A crosssectional study was conducted upon 500 postpartum females attending primary health care facilities in the Qaliubeya governorate. Data were collected by an interview questionnaire which included data about sociodemographic, obstetric, and past history and the Arabic version of DASS for assessment of postpartum depression and/or anxiety. The results showed 1.6% of the studied females suffered postpartum depression alone, 10% suffered from anxiety alone, and 21.2% suffered from both. The mean age of female who suffered from comorbid depression and anxiety was significantly (p=0.01) higher than the normal group (26.9 and 25.1, respectively), and they had a significantly lower socioeconomic score than the normal ones (31.1 and 34.1, respectively), p < 0.05. There was a significant association (p < 0.001) between the past history of similar conditions and the current prevalence of postpartum disorders. ROC curve analysis showed that the progesterone level ≤4.6, ≤11.3, and ≤2.8 significantly predict depression alone, anxiety alone, and comorbid diseases, respectively. It was concluded that postpartum depression and/or anxiety affect 32.8% of females in the Qaliubeya governorate. Very low socioeconomic level, lower educational levels, past history of similar conditions, and low progesterone level are the significant predictors.

Prevalence of HCV Infection in Household Contacts of Chronic Liver Diseases Cases in Egypt.

Background: Egypt has the highest prevalence of HCV infection worldwide. This project aimed at identifying the role of HCV transmission among household contacts to index cases in the persistent high incidence of HCV infection in Egypt. Methods: This cross-sectional study recruited 70 Egyptian cases with chronic liver diseases and their household contacts (140 contacts) from Qalubeyia Governorate. An interview questionnaire was used to collect information on sociodemographic characteristics and risk factors to HCV infection. HCV-RNA was tested using real-time polymerase chain reaction (PCR). Univariate and multivariate analyses were carried out to estimate the risk of HCV infection among contacts. Results: HCV viremia was detected in 85.7% of cases and 20% of contacts. HCV-RNA was detected in higher proportion of household contacts to cases than the general population. Contacts to HCV-positive cases were unlikely exposed to used syringe (P=0.02) and unlikely to have history of Bilharziasis (P=0.001) compared to contacts to HCV-negative cases. HCV-positive contacts were more likely older (P < 0.001) and married (P=0.008) and had higher crowding index (P=0.04) than HCV-negative contacts. Also, HCV-positive contacts were more likely exposed to blood transfusion (P=0.008) and shaving at community barber (P=0.04) and had history of Bilharziasis (P=0.01). The strongest predictors for HCV infection among contacts were old age (OR, 95% CI: 1.08, 1.02 to 1.15; P=0.01) and blood transfusion (8.08, 1.75 to 37.3; P=0.007). Conclusion: Nonetheless, household contacts to HCV cases are exposed to increased risk of HCV infection, and environmental exposure particularly blood transfusion remained a major source of HCV infection.

Revisiting the management of recurrent implantation failure through freeze-all policy.

OBJECTIVE: To determine whether a freeze-all policy for in vitro human blastocysts improves the ongoing pregnancy rate in patients with recurrent implantation failure (RIF). DESIGN: Prospective cohort study. SETTING: Single private center. PATIENT(S): A total of 171 women with RIF divided into two groups: freeze-all policy group (n = 81) and fresh embryo transfer (ET) group (n = 90). INTERVENTION(S): Freeze-all policy. MAIN OUTCOME MEASURE(S): Ongoing pregnancy rate. RESULT(S): The clinical pregnancy rate (52% vs. 28%; odds ratio [OR] 1.86; 95% confidence interval [CI], 1.29-2.68) and ongoing pregnancy rate (44% vs. 20%; OR 2.2; 95% CI, 1.04-3.45) were statistically significantly higher in the freeze-all group than the fresh ET group, respectively. The implantation rate was also statistically significant (freeze-all group 44.2% vs. fresh ET group 15.8%; OR 2.80; 95% CI, 2.00-3.92). CONCLUSION(S): The freeze-all policy statistically significantly improved the ongoing pregnancy and implantation rates. Thus, a freeze-all policy is likely to be the new key to helping open the black box of RIF. These findings also are useful for further investigating the adverse effect of controlled ovarian stimulation on in vitro fertilization outcomes.

Does vitamin C have the ability to augment the therapeutic effect of bone marrow-derived mesenchymal stem cells on spinal cord injury?

Methylprednisolone (MP) is currently the only drug confirmed to exhibit a neuroprotective effect on acute spinal cord injury (SCI). Vitamin C (VC) is a natural water-soluble antioxidant that exerts neuroprotective effects through eliminating free radical damage to nerve cells. Bone marrow mesenchymal stem cells (BMMSCs), as multipotent stem cells, are promising candidates in SCI repair. To evaluate the therapeutic effects of MP, VC and BMMSCs on traumatic SCI, 80 adult male rats were randomly divided into seven groups: control, SCI (SCI induction by weight-drop method), MP (SCI induction, followed by administration of 30 mg/kg MP via the tail vein, once every other 6 hours, for five times), VC (SCI induction, followed by intraperitoneal administration of 100 mg/kg VC once a day, for 28 days), MP + VC (SCI induction, followed by administration of MP and VC as the former), BMMSCs (SCI induction, followed by injection of 3 × 106 BMMSCs at the injury site), and BMMSCs + VC (SCI induction, followed by BMMSCs injection and VC administration as the former). Locomotor recovery was assessed using the Basso Mouse Scale. Injured spinal cord tissue was evaluated using hematoxylin-eosin staining and immunohistochemical staining. Expression of transforming growth factor-beta, tumor necrosis factor-alpha, and matrix metalloproteinase-2 genes was determined using real-time quantitative PCR. BMMSCs intervention better promoted recovery of nerve function of rats with SCI, mitigated nerve cell damage, and decreased expression of transforming growth factor-beta, tumor necrosis factor-alpha, and matrix metalloproteinase-2 genes than MP and/or VC. More importantly, BMMSCs in combination with VC induced more obvious improvements. These results suggest that VC can enhance the neuroprotective effects of BMMSCs against SCI.