Effect of caring leadership intervention program for first-line nurse managers on their managerial actions and nurse outcomes.

AIM: The aim of the study was to examine the effect of a caring leadership intervention program for first-line nurse managers (FLNM) on their caring knowledge and managerial actions as well as nurses' perceived FLNM caring behaviours and nurse outcomes. DESIGN: A quasi-experimental study design was implemented on two groups; study and control, including 30 FLNM and 150 nurses for each. METHODS: Self-report questionnaires about FLNMs' knowledge of caring behaviours and their managerial actions, nurses perceived line nurse managers' caring behaviours and nurses' outcomes (job satisfaction and work engagement) were utilized to collect study data from 1 July 2022 to 30 December 2022. RESULTS: A statistically significant difference and changes were revealed between the study and control groups in FLNMs' caring knowledge and their managerial actions, and nurses' perceived FLNMs' caring behaviours, nurses' job satisfaction and nurses' work engagement during post-test in comparison to pre-test. Higher total mean scores of post-test in the study group were recorded compared to those of control group regarding FLNMs' caring knowledge and their managerial actions as well as nurses 'perceived FLNMs' caring behaviour, job satisfaction and work engagement. CONCLUSION: The caring leadership intervention program for FLNMs was highly effective in enhancing their caring knowledge and managerial actions as well as nurses' perceived FLNM caring behaviours and nurse outcomes. IMPLICATIONS FOR THE PROFESSION: Caring leadership can help FLNMs to create a healthy environment, resulting in a positive outcome for nurse staff, patients and healthcare organizations. PATIENT AND PUBLIC CONTRIBUTION: No patient and public contribution.

Management of presumed trematode induced granulomatous uveitis in pediatric patients.

PURPOSE: To outline the management of newly identified trematode induced uveitis in pediatric patients STUDY DESIGN: Prospective interventional case series METHODS: Patients with distinctive uveitis were recruited to either receive steroid monotherapy or undergo surgical excision of the inflammatory lesions based on a scoring system. Outcome measures included best corrected visual acuity (BCVA), intraocular inflammatory activity, and incidence of ophthalmic complications RESULTS: 170 patients (174 eyes) were recruited. Mean age was 11.1 years. Mean initial decimal BCVA (± SD) was 0.58 (± 0.31). Of 116 eyes with disease scores <5, 109 were treated effectively with steroids (93.97%). Surgical excision was offered to 58 patients and proved curative in the treated eyes. Protracted inflammation with persistence of the granulomas was noted in 5 patients refusing surgery. Mean follow up period was 21.5 months. Mean final BCVA was 0.69 (±0.27). A significant change in BCVA was noted (p=0.002). There has not been a need for retreatment in any of the study patients, who were also given instructions on evading exposure to fresh water habitats. Larger lesions, mixed disease morphology, older age at presentation were associated with higher rates of ophthalmic complications and vision loss CONCLUSION: A novel waterborne trematode inducing uveitis has been identified in Egypt. A favorable response to steroid monotherapy is demonstrated in low grade disease, while surgical excision was found to be curative in patients with larger lesions or those showing suboptimal response to medical treatment.

Surveillance and Molecular Identification of Acanthamoeba and Naegleria Species in Two Swimming Pools in Alexandria University, Egypt.

BACKGROUND: Swimming in contaminated water was reported to be associated with Acanthamoeba and N. fowleri human infections. The present study was carried out with the aim of isolation and identification of the different species of Acanthamoeba and Naegleria from two swimming pools in Alexandria University. METHODS: Samples were collected from the swimming pools of Alexandria University Stadium and Faculty of Agriculture-Alexandria University during the period from May 2012 to April 2013. RESULTS: Free-living amoebae were prevalent in the collected samples. Molecular characterization confirmed the identity of ten Acanthamoeba isolates and seven Naegleria isolates. Acanthamoeba T3, T4, T5, T11 and T15 genotypes were identified. Acanthamoeba T4 was the most prevalent genotype. CONCLUSION: The relatively high prevalence of Acanthamoeba, especially genotype T4, indicates the presence of a health hazard to swimmers particularly those wearing contact lenses. Naegleria fowleri was not found during the present study.

Plague in Egypt: Disease biology, history and contemporary analysis: A minireview.

Plague is a zoonotic disease with a high mortality rate in humans. Unfortunately, it is still endemic in some parts of the world. Also, natural foci of the disease are still found in some countries. Thus, there may be a risk of global plague re-emergence. This work reviews plague biology, history of major outbreaks, and threats of disease re-emergence in Egypt. Based on the suspected presence of potential natural foci in the country, the global climate change, and the threat posed by some neighbouring countries disease re-emergence in Egypt should not be excluded. The country is in need for implementation of some preventive measures.

Evaluation of a method for induction of praziquantel resistance in Schistosoma mansoni.

CONTEXT: Praziquantel (PZQ) is a highly efficacious anthelmintic against many flatworms including schistosomes. PZQ has been in use for more than 25 years, and concern is increasing that resistance has emerged in human schistosomes in Egypt and other endemic countries. OBJECTIVE: The current study was designed to evaluate a recently described method for induction of PZQ resistance in Schistosoma mansoni. MATERIALS AND METHODS: Successive subcurative drug treatments of Biomphalaria alexandrina snails infected with an Egyptian strain of S. mansoni were undertaken. Cercariae shed from snails exposed and unexposed to PZQ were used to infect mice. Forty-five days after infection, mice were treated with a single oral dose of PZQ in 2% aqueous solution of Cremophor-EL®. The concentration of PZQ was 0, 200, 400, or 800 mg/kg. Thirty-three days after treatment, all groups of mice were dissected to collect the S. mansoni worms by the perfusion technique. In addition, the oogram pattern was examined to study the production, maturity, and death of S. mansoni eggs in the different groups of mice. RESULTS: The present study has shown that the sublethal dose for induction of PZQ resistance in the intra-molluscan S. mansoni stages was 500 mg/kg. The worm count and the percentage of immature eggs in different groups of mice were significantly affected by the intra-molluscan exposure to PZQ and the drug concentration used to treat infected mice. DISCUSSION AND CONCLUSION: The results obtained herein confirm the possibility of using successive drug treatments of infected B. alexandrina to induce PZO resistance in S. mansoni.

Climate change and epidemiology of human parasitosis in Egypt: A review.

Climate change is an emerging global issue. It is expected to have significant impacts both in Egypt and around the world. Thus, the country is in need for taking action to prepare for the unavoidable effects of climate change, including the increase in water stress, the rise in sea level, and the rapidly increasing gap between the limited water availability and the escalating demand for water in the country. Also, weather and climate play a significant role in people's health. Direct impacts of climate change on the Egyptians public health may include also increased prevalence of human parasitic diseases. Climate could strongly influence parasitic diseases transmitted through intermediate hosts. The present work reviews the future of such parasitic diseases in the view of the current available evidence and scenarios for climate change in the Egypt.

Application and evaluation of a molecular approach for detection of the schistosomicidal effect of Mirazid® (myrrh) in the murine model.

The conventional PCR technique was used for studying the schistosomicidal effect of Mirazid® in the murine model. Results of the molecular study were compared with the parasitological results (ova and worm count). The used PCR technique was more sensitive than the Kato-Katz thick smears. Mirazid® showed some schistosomicidal effects against murine Schistosoma mansoni. However, it was not efficient enough to cure any of the studied mice.

Genotyping natural infections of Schistosoma mansoni in Biomphalaria alexandrina from Damietta, Egypt, with comparisons to natural snail infections from Kenya.

The distribution of Schistosoma genotypes among individuals in snail populations provides insights regarding the dynamics of transmission and compatibility between schistosome and snail hosts. A survey of Biomphalaria alexandrina from Damietta (Nile Delta, Egypt), an area subjected to persistent schistosomiasis control efforts, provided only 17 snails infected with Schistosoma mansoni (6.1% overall prevalence), each shown by microsatellite analysis to have a single genotype infection. By contrast, recent studies of uncontrolled S. mansoni transmission foci in Kenya revealed that 4.3% Biomphalaria pfeifferi and 20-25% Biomphalaria sudanica snails had multiple genotype infections. Compared with the 3 Kenyan populations, the Egyptian population of S. mansoni also showed a lesser degree of genetic variability and was genetically differentiated from them. We suggest that tracking of genotype diversity in infected snails could be further developed to serve as an additional and valuable independent indicator of efficacy of schistosomiasis control in Egypt and elsewhere.

A molecular approach for identification of paramphistomes from Africa and Asia.

Paramphistomiasis is a disease of domestic and wild ruminants caused by some digenetic trematodes of the superfamily Paramphistomoidea. Human infections with certain species of paramphistomes have been reported. Given their ubiquity and their abundance within hosts, it seems likely that the importance of these worms is underestimated globally. Based on the reported difficulties of morphological identification of paramphistomes, the development of alternative approaches to better delineate species is needed. Paramphistome samples examined during this study were cercariae, rediae from snail hosts and adult flukes obtained from slaughterhouses from Kenya, Tanzania, Egypt and Nepal. The results confirm that ITS2 is a good molecular marker for paramphistome identification and can be used to determine the affiliation of samples among the different taxa of Paramphistomoidea. Our 22 samples include eight species of paramphistomes. Ten samples of paramphistome larvae (cercariae or rediae) yielded seven species and the 12 samples of adult flukes from bovines yielded four, only one of which was not also represented among the larvae. We found three cases in which the sequences for adult worms and larvae matched, thus revealing the hosts involved locally in those particular life cycles. We interpret our specimens to include five species from Kenya, two from Nepal, two from Tanzania and one from Egypt. Bulinus forskalii was found infected with three species of paramphistomes. The results of the present study will help construct a framework to facilitate identification and eventually control of this underestimated cosmopolitan group of digeneans.

Evolutionary origins, diversification, and biogeography of liver flukes (Digenea, Fasciolidae).

Fasciolid flukes are among the largest and best known digenetic trematodes and have considerable historical and veterinary significance. Fasciola hepatica is commonly implicated in causing disease in humans. The origins, patterns of diversification, and biogeography of fasciolids are all poorly known. We have undertaken a molecular phylogenetic study using 28S, internal transcribed spacer 1 and 2 (ITS-1 and ITS-2) of nuclear ribosomal DNA, and mitochondrial nicotinamide dehydrogenase subunit 1 (nad1) that included seven of the nine recognized species in the family. The fasciolids examined comprise a monophyletic group with the most basal species recovered from African elephants. We hypothesize fasciolids migrated from Africa to Eurasia, with secondary colonization of Africa. Fasciolids have been conservative in maintaining relatively large adult body size, but anatomical features of their digestive and reproductive systems are available. These flukes have been opportunistic, with respect to switching to new snail (planorbid to lymnaeid) and mammalian hosts and from intestinal to hepatic habitats within mammals.

A molecular survey of biomphalaria in Egypt: is B. glabrata present?

Two species of Biomphalaria are reported from Egypt, the indigenous Biomphalaria alexandrina and Biomphalaria glabrata, the latter believed to be introduced during the past few decades. Both are known to be excellent hosts of Schistosoma mansoni, the human-infecting blood fluke common in Egypt. Given the concerns regarding the spread of the exotic B. glabrata, this study was carried out to get a more current picture of the status of Biomphalaria in Egypt. Snail collections were undertaken during 2002-2003 from regions between Alexandria and Ismailia in the north of the Nile Delta, to as far south as Abu Simbel at Lake Nasser. Biomphalaria snails were found in 37 out of 76 sampled localities and were widely distributed in the Nile Delta and along the Nile as far south as Aswan. According to the results of species-specific polymerase chain reaction assays that sampled both nuclear and mitochondrial genomes, and according to DNA sequence data, all Biomphalaria collected during this survey were B. alexandrina. There was no evidence of the presence of B. glabrata or of hybridization of B. alexandrina with B. glabrata in the examined sites. The results were surprising given that some field-collected snails strongly resembled B. glabrata in both size and conchology and that previous survey work suggested B. glabrata had established in Egypt. Continued scrutiny to ascertain the possible presence of B. glabrata in Egypt is warranted. Also, the planorbid Helisoma duryi was detected in the Delta and as far south as Aswan, so it is important for Egyptian schistosomiasis workers to accurately distinguish this non-schistosome-transmitting snail from Biomphalaria.

Specific identification of Egyptian Biomphalaria species and possible hybrids using the polymerase chain reaction based on nuclear and mitochondrial loci.

The snail historically implicated in the transmission of Schistosoma mansoni in Egypt is Biomphalaria alexandrina. The problem of schistosomiasis in Egypt has been complicated in recent years by the introduction of Biomphalaria glabrata, which has been reported to hybridize with B. alexandrina. Both introduced and hybrid snails also pose a threat with respect to S. mansoni transmission. As morphological differentiation of these snails is difficult, using three DNA loci, nuclear ITS1 and ITS2, and mitochondrial ND1, PCR-based assays were developed to identify these species and possible hybrids. The assays are rapid, reproducible, sensitive and specific. This technique may be used in field surveys to study the distribution of the two species of intermediate host and their putative hybrids in Egypt.

Efficacy of praziquantel against Giardia lamblia in rats: parasitological, pathological and therapeutic study.

Rats were divided into two experimental groups received single or split doses of PZQ, and two control groups one infected untreated and the other normal healthy rats. The effect of infection on rat growth, on jejunal and duodenal architecture were studied histopathologically after H&E staining. The jejunal ultrastructure was examined by SEM and TEM. The effect of PZQ was evaluated using the same techniques. It was observed that infected as well as infected treated animals gained less weight than healthy control. Intensity of infection decreased gradually after treatment. Cure rate was 100% after split dose and 80% after a single dose. Altered villus height and cryptic depth were the characteristic changes in the architecture of the duodenum and jejunum, more pronounced in the latter. Split dose of PZQ revealed more improvement of the histopathological findings than a single dose. By SEM, circular imprints representing defects in the villi were observed in the jejunum. By TEM deformation of microvillar architecture was observed together with organellar changes in the RER and the mitochondria, after PZQ treatment.

A comparative study on the effect of praziquantel and triclabendazole on Vampirolepis nana in vitro.

V. nana was frequently associated with Schistosoma mansoni and Fasciola spp. This study was conducted to investigate and compare the effects of praziquantel and triclabendazole on V. nana worms, after in vitro exposure to 1 and 2 microg/ml of each of praziquantel or triclabendazole. All the worms were put under observation for 30 minutes. The worm mortality rates were recorded and the topographic tegumental changes were studied by scanning electron microscopy. The results demonstrated that praziquantel showed comparatively superior effect on adult V. nana worms than triclabendazole. The latter still revealed an anthelmintic effect.