Green synthesis of zinc oxide/Allium sativum nano-composite and its efficacy against murine cryptosporidiosis.

Cryptosporidiosis is a global health problem threats life of immunocompromised patients. Allium sativum (A. sativum) is one of the therapeutic options for cryptosporidiosis. This study develops green synthesized ZnO-NPs based on A. sativum extract, and assesses its therapeutic application in treating experimental cryptosporidiosis in immunosuppressed mice. FTIR, scanning electron microscopy, and zeta analyzer were used for characterization of bio ZnO-NPs. The morphology of prepared materials appeared as sponge with many pores on the whole surface that allows the feasibility of bio ZnO-NPs for different biological activities. Its structural analysis was highly stabilized with negative charge surface which indicated for well distribution into the parasite matrix. Twenty-five immunosuppressed Cryptosporidium parvum infected mice, classified into 5 groups were sacrificed at 21th day after infection with evaluation of parasitological, histopathological, oxidative, and proinflammatory biomarkers. Treated mice groups with 50 and 100 mg/kg of AS/ZnO-NPs showed a highly significant decline (79.9% and 83.23%, respectively) in the total number of expelled oocysts. Both doses revealed actual amelioration of the intestinal, hepatic, and pulmonary histopathological lesions. They also significantly produced an increase in GSH values and improved the changes in NO and MDA levels, and showed high anti-inflammatory properties. This study is the first to report green synthesis of ZnO/A. sativum nano-composite as an effective therapy in treating cryptosporidiosis which gave better results than using A. sativum alone. It provides an economical and environment-friendly approach towards novel delivery synthesis for antiparasitic applications. RESEARCH HIGHLIGHTS: Green synthesis of ZnO-NPs was developed using A. sativum extract. The morphology of prepared ZnO-NPs appeared as sponge with many pores on SEM The study evaluates its therapeutic efficacy against murine cryptosporidiosis The green synthesized ZnO-NPs significantly reduced percent of oocyst shedding, improved the pathological changes, and showed high antioxidant and anti-inflammatory potentials.

Use of encapsulated pomegranate seed oil in novel coarse and nanosized materials for improving the storage life of strawberry.

Different-sized pomegranate seed oil-based emulsions (coarse (CsP) and nanoemulsions (NsP): 1246 and 325 nm) were successfully prepared. Strawberries treated with NsP and CsP showed a significant decrease (p < 0.05) in yeast-mold counts (TMY) by 1.80 log CFU g-1, and mesophilic aerobic bacteria counts (TMAB) decreased (p < 0.05) by 0.91 log CFU g-1, respectively. CsP- and NsP-treated strawberries had a TPC of 74.45 and 82.35 mg GAE kg-1, respectively, while control samples had a TPC of 44.24 mg GAE kg-1. The strawberries treated with NsP exhibited the highest antioxidant capacity with 179.44 mol TEAC g-1. After treatment with a coarse emulsion, severity levels of A. niger and B. cinerea were 60 and 73 % while the nanoemulsion treatment significantly reduced severity levels to 55.3 and 56 %. The coarse and nanoemulsions may have potential use within the food industry owing to their antioxidant and antifungal properties as well as their ability to enhance strawberry quality and function.

Newly fabricated zinc oxide nanoparticles loaded materials for therapeutic nano delivery in experimental cryptosporidiosis.

Cryptosporidiosis is a global health problem that threatens the lives of immunocompromised patients. This study targets to fabricate and investigate the efficiency of zinc oxide nanoparticles (ZnO-NPs), nitazoxanide (NTZ)-loaded ZnO-NPs, and Allium sativum (A. sativum)-loaded ZnO-NPs in treating cryptosporidiosis. Further FTIR, SEM, XRD, and zeta analysis were used for the characterization of ZnO-NPs and loaded materials. The morphology of loaded materials for ZnO-NPs changed into wrapped layers and well-distributed homogenous particles, which had a direct effect on the oocyst wall. The charge surface of all particles had a negative sign, which indicated well distribution into the parasite matrix. For anti-cryptosporidiosis efficiency, thirty immunosuppressed Cryptosporidium parvum-infected mice, classified into six groups, were sacrificed on the 21st day after infection with an evaluation of parasitological, histopathological, and oxidative markers. It was detected that the highest reduction percent of Cryptosporidium oocyst shedding was (81.5%) in NTZ, followed by (71.1%) in A. sativum-loaded ZnO-NPs-treated groups. Also, treatment with A. sativum and NTZ-loaded ZnO-NPs revealed remarkable amelioration of the intestinal, hepatic, and pulmonary histopathological lesions. Furthermore, they significantly produced an increase in GSH values and improved the changes in NO and MDA levels. In conclusion, this study is the first to report ZnO-NPs as an effective therapy for treating cryptosporidiosis, especially when combined with other treatments that enhance their antioxidant activity. It provides an economical and environment-friendly approach to novel delivery synthesis for antiparasitic applications.

Diversity and Distribution Characteristics of Viruses from Soda Lakes.

Viruses are the most abundant living things and a source of genetic variation. Despite recent research, we know little about their biodiversity and geographic distribution. We used different bioinformatics tools, MG-RAST, genome detective web tools, and GenomeVx, to describe the first metagenomic examination of haloviruses in Wadi Al-Natrun. The discovered viromes had remarkably different taxonomic compositions. Most sequences were derived from double-stranded DNA viruses, especially from Myoviridae, Podoviridae, Siphoviridae, Herpesviridae, Bicaudaviridae, and Phycodnaviridae families; single-stranded DNA viruses, especially from the family Microviridae; and positive-strand RNA viruses, especially from the family Potyviridae. Additionally, our results showed that Myohalovirus chaoS9 has eight Contigs and is annotated to 18 proteins as follows: tail sheath protein, tco, nep, five uncharacterized proteins, HCO, major capsid protein, putative pro head protease protein, putative head assembly protein, CxxC motive protein, terl, HTH domain protein, and terS Exon 2. Additionally, Halorubrum phage CGphi46 has 19 proteins in the brine sample as follows: portal protein, 17 hypothetical proteins, major capsid protein, etc. This study reveals viral lineages, suggesting the Virus's global dispersal more than other microorganisms. Our study clarifies how viral communities are connected and how the global environment changes.

Anti-Cryptosporidium efficacy of Citrus sinensis peel extract: Histopathological and ultrastructural experimental study.

BACKGROUND: Cryptosporidiosis is a crucial zoonotic global health concern which can be treated by alternative medicinal plants extracts. AIM OF THE STUDY: The study was carried out to assess the therapeutic efficacy of Citrus sinensis peel ethanolic extract on Cryptosporidium-infected mice. METHODS: Two doses of Citrus sinensis extract; high dose (30 mg/kg) and low dose (15 mg/kg) were investigated compared to the common commercial drug nitazoxanide (NTZ). Assessment of the extract was carried out by calculating oocysts count in fecal samples, in addition to histopathological and electron microscopic examination of intestinal mucosa.. RESULTS: There was a statistically significant reduction in the percentage of oocyst shedding more in high dose than low dose Citrus-treated mice group till negligible numbers of oocysts were found at day 22nd post infection. Histopathologically, the intestinal tissues from high dose Citrus-treated group showed improvement of the pathological changes, the villi retained their normal appearance with minimal inflammatory cells in comparison to infected control mice groups. Also, ultra-structurally, the high dose Citrus-treated mice showed few Cryptosporidium trophozoites, while moderate number of parasitic stages and mucous in the low dose Citrus-treated mice, and large numbers of parasitic stages with sever mucous in the control infected non-treated mice epithelium. CONCLUSION: Our study established for the first time that Citrus sinensis is a promising natural candidate that could be efficiently used for developing of new anti-cryptospordial drugs.

Diagnosis of coronavirus disease 2019 and the potential role of deep learning: insights from the experience of Cairo University Hospitals.

OBJECTIVES: Early detection of coronavirus disease 2019 (COVID-19) is crucial for patients and public health to ensure pandemic control. We aimed to correlate clinical and laboratory data of patients with COVID-19 and their polymerase chain reaction (PCR) results and to assess the accuracy of a deep learning model in diagnosing COVID-19. METHODS: This was a retrospective study using an anonymized dataset of patients with suspected COVID-19. Only patients with a complete dataset were included (n = 440). A deep analytics framework and dual-modal approach for PCR-based classification was used, integrating symptoms and laboratory-based modalities. RESULTS: Participants with loss of smell or taste were two times more likely to have positive PCR results (odds ratio [OR] 1.86). Participants with neutropenia, high serum ferritin, or monocytosis were three, four, and five times more likely to have positive PCR results (OR 2.69, 4.18, 5.42, respectively). The rate of accuracy achieved using the deep learning framework was 78%, with sensitivity of 83.9% and specificity of 71.4%. CONCLUSION: Loss of smell or taste, neutropenia, monocytosis, and high serum ferritin should be routinely assessed with suspected COVID-19 infection. The use of deep learning for diagnosis is a promising tool that can be implemented in the primary care setting.

Accuracy of the Traditional COVID-19 Phone Triaging System and Phone Triage-Driven Deep Learning Model.

OBJECTIVES: During the COVID-19 pandemic, a quick and reliable phone-triage system is critical for early care and efficient distribution of hospital resources. The study aimed to assess the accuracy of the traditional phone-triage system and phone triage-driven deep learning model in the prediction of positive COVID-19 patients. SETTING: This is a retrospective study conducted at the family medicine department, Cairo University. METHODS: The study included a dataset of 943 suspected COVID-19 patients from the phone triage during the first wave of the pandemic. The accuracy of the phone triaging system was assessed. PCR-dependent and phone triage-driven deep learning model for automated classifications of natural human responses was conducted. RESULTS: Based on the RT-PCR results, we found that myalgia, fever, and contact with a case with respiratory symptoms had the highest sensitivity among the symptoms/ risk factors that were asked during the phone calls (86.3%, 77.5%, and 75.1%, respectively). While immunodeficiency, smoking, and loss of smell or taste had the highest specificity (96.9%, 83.6%, and 74.0%, respectively). The positive predictive value (PPV) of phone triage was 48.4%. The classification accuracy achieved by the deep learning model was 66%, while the PPV was 70.5%. CONCLUSION: Phone triage and deep learning models are feasible and convenient tools for screening COVID-19 patients. Using the deep learning models for symptoms screening will help to provide the proper medical care as early as possible for those at a higher risk of developing severe illness paving the way for a more efficient allocation of the scanty health resources.

Consensus Meeting Report "Technology Enhanced Assessment" in Covid-19 Time, MENA Regional Experiences and Reflections.

PURPOSE: Majority of the assessments, appraisals and placements have been disturbed, with some being cancelled, postponed, or modified in design. New approaches for assessment should be well-thought-out. This work attempts at capturing the collective wisdom of educators in the Middle East and North Africa region (MENA), providing an understanding of the online assessment conceptual framework in the era of COVID-19 that tells the story rather than determining cause and effect, and identifying the biggest gaps that derail the digital transformation. METHODS: A qualitative inductive study using the grounded theory approach was implemented following a synchronous virtual online meeting, a summary of the reflections as well as experiences of medical education experts was prepared. Data for this qualitative study were collected from the meeting. The meeting was video-recorded and transcribed by the researchers. Thematic analysis was performed by three separate researcher coders. The authors then discussed together until they reached a consensus. RESULTS: Three main thematic areas were identified: 1) feasibility, 2) exam fairness/equity and 3) acceptable graduate attributes, society/community acceptance. CONCLUSION: The COVID-19 era necessitated revisiting of our assessment strategies to cope with new changes within the available context. Rapid adaptation is required.

Establishment of actinobacteria-Satureja hortensis interactions under future climate CO2-enhanced crop productivity in drought environments of Saudi Arabia.

Drought is a significant global constraint on agricultural production and food security. As a promising approach to improve plant growth and yield under challenging conditions, plant growth-promoting actinobacteria has attracted much interest. Further, elevated levels of atmospheric CO2 (eCO2) may promote the plant-actinobacteria interactions which could be effective to improve the plant growth for food production. Herein, we have investigated the impact of actinobacteria and/or CO2 on biomass production, photosynthesis, macronutrients, levels of organic acids, amino acids, and essential oils as well as antioxidant activities of Satureja hortensis under water-deficit conditions. Among different actinobacterial isolates evaluated for development of secondary metabolites and biological activities, Ac9 was highly capable of producing flavonoids, and it also showed high antioxidant and microbial activities. It markedly induced the plant growth, photosynthesis, and global metabolic improvement, under water-deficit conditions. Interestingly, treatment with Ac9 in combination with eCO2 substantially minimized drought stress-induced biomass and photosynthesis reductions in Satureja hortensis. Improved photosynthesis by Ac9 and/or eCO2 induced the primary and secondary metabolisms in drought-stressed plants. The levels of the majority of the detected organic acids, essential oil, and amino acids were further improved as a result of the synergistic action of Ac9 and eCO2, as compared to the individual treatments. Furthermore, Ac9 or eCO2 significantly improved the antioxidant activities in stressed plants; however, much more positive impact was obtained by their synchronous application. Thus, the current study suggests that actinobacterial treatment induces global metabolic changes in water-stressed Satureja hortensis, the effects that have been much more strengthened under eCO2.

An Adapted Online Family Medicine Training for House Officers Amid Covid-19 Pandemic in Egypt.

INTRODUCTION: The COVID-19 pandemic is an unprecedented challenge to house officers training programs because of the safety measures. OBJECTIVE: This current study aimed to introduce the adaptation of family medicine training for house officers during COVID-19 pandemic and gauge their level of satisfaction with the training. METHODS: Unfortunately, more than one-fourth of the house officers attending the family medicine training turned out to be hospital-admitted or in obligatory home isolation. A time-sensitive plan was proposed to maintain a competent training guaranteeing safety and support of house officers and fulfilling the training objectives in a virtual setting. Three mentors were assigned to each 10 house officers to provide continuous support and monitoring. Tutor and house officer interaction and reflection were maintained through a virtual clinical training session via Zoom application and a daily online discussion of a clinical scenario. Peer interaction was provided through post-webinar and small-group online discussion sessions. RESULTS: The adapted training was applied on thirteen cohorts of house officers. The response rate was 70% (666 out of 950). Most of them were satisfied with the training (84.6%). Their satisfaction with each modality of the training was encouraging. CONCLUSIONS: During COVID-19 pandemic, successful adaptation of family medicine training has succeeded in fulfilling the training objectives and providing psychological support and engagement for house officers without burdening the hospital-admitted and home-isolated house officers.

Barriers to Completing Therapy for Hepatitis C with Direct-Acting Antivirals: A Real-Life Experience from a Single Treatment Center in Egypt.

INTRODUCTION: Interferon-based therapies against the hepatitis C virus had a poor adherence profile. On the other hand, new direct-acting antivirals (DAAs) are orally administered medications, show high efficacy against the hepatitis C virus in addition to a high safety profile. Therefore, adherence to this treatment is expected to improve. Assessment for treatment adherence is mandatory to assess the feasibility of achieving viral hepatitis elimination. AIM: The study aims to assess the adherence rate and causes of non-adherence in Egyptian hepatitis C patients who received interferon-free treatment regimens. METHODS: Retrospective data analysis for 668 hepatitis C patient's records from August 2014 to October 2019 was done. Assessment of treatment adherence was done by revising the records and phone calls. However, 172 patients were excluded due to the absence of contact data. Rest of patients (n = 496) was categorized into 2 groups: Adherent (n = 432) and non-adherent (n = 64). For whom comparative analysis was done. RESULTS: The adherent group (87%) achieved 100 % sustained virological response after 12 weeks (SVR 12). Non-adherence was reported in 12.9% of patients. Low awareness was the main cause of non-adherence (43.75%). BMI was the only significant risk factor for poor adherence (P = .04). Other Patient demographics, clinical, and laboratory data didn't show any significant differences between both groups. CONCLUSION: Interferon-free regimens are tolerable. Raising awareness is mandatory for proper treatment adherence and, subsequently, good clinical outcomes.

Phoenix dactylifera, mentha piperita and montanide™ ISA-201 as immunological adjuvants in a chicken model.

This study evaluated plant-based immune-adjuvants from crude extracts of Phoenix dactylifera and Mentha piperita as promising adjuvants for vaccines because of the limited side effects associated with plant extracts. In addition, Montanide™ ISA 201 previously used in vaccines in cattle. Eight different infectious coryza (IC) vaccines were prepared from three serovars [A (W strain and local strain), C (Modesto strain) and B (0222 strain)] with eight Avibacterium paragallinarum vaccines adjuvants formulae using liquid paraffin, Montanide™ ISA 71, Montanide™ ISA 201, and Montanide™ Gel adjuvants, P. dactylifera and M. piperita as immune-stimulants at a concentration of 1 mg and 2 mg incorporated with or without liquid paraffin oil as an adjuvant. These vaccines were applied in a chicken model. After a single immunization, the eight vaccine formulations were evaluated using the ELISA and Microplate agglutination test. Evidence of protection in the immunized birds was based on the results after challenge and bacterial isolation. The incorporation of the crude aqueous extract of P. dactylifera or M. piperita at a concentration of 2 mg in a liquid paraffin oil adjuvanted IC vaccine could be employed as an efficient adjuvant for chicken to IC vaccine to enhance immune responses. Also,Montanide™ ISA 201 may be the best adjuvant to be used to enhance the protective response against Av. paragallinarum. Our results confirm that aqueous extracts of M. piperita leaves and P. dactylifera fruit have immunomodulatory potentials in vivo and elevated serum antibodies against Av. Paragallinarum.

Primary Health Care Physicians' Adherence and Attitude Towards Integrated Management of Childhood Illness Guidelines in Alexandria Governorate in Egypt.

BACKGROUND: Integrated Management of Childhood Illness (IMCI) is a cost-effective strategy that improves the quality of care provided to under - five children. Alexandria was the first governorate that applied the Integrated Management of Childhood Illness guidelines in Egypt. The aim of this study was to assess the degree of primary health care physicians' adherence and attitude towards those guidelines after 17 years of application. METHODS: This cross-sectional study was carried out on a representative sample from the primary health care facilities in Alexandria from which physicians using IMCI guidelines were included in the study. The sample units were chosen randomly from all districts of Alexandria. Observational checklists were developed to assess the degree of adherence of physicians based on the guidelines booklet. RESULTS: The highest adherence score reported was that of writing disease classification (100%). As regards infants aged up to 2 months, the highest physicians' adherence score reported was that of jaundice and possible bacterial infection assessment (100 % and 95% respectively). And in spite of its importance, only 85.7% of physicians were complied with weight assessment and its plotting in the growth curve. For children aged from 2 months up to 5 years physicians were generally well complied with the guidelines especially for assessment of dangerous signs and possible bacterial infection. CONCLUSION: Despite being applied for years, IMCI guidelines still show certain areas of poor adherence, an issue that need further investigation in order to maximize physicians' adherence and achieve the best of their performance.

Analysis of FHIT gene methylation in egyptian breast cancer women: association with clinicopathological features.

BACKGROUND: Fragile histidine triad (FHIT) gene is a tumor suppressor gene which involved in breast cancer pathogenesis. Epigenetics alterations in FHIT contributes to tumorigenesis of breast cancer. OBJECTIVE: Our objective was to study FHIT promoter region hypermethylation in Egyptian breast cancer patients and its association with clinicopathological features. MATERIALS AND METHODS: Methylation-specific polymerase chain reaction was performed to study the hypermethylation of FHIT promoter region in 20 benign breast tissues and 30 breast cancer tissues. RESULTS: The frequency of hypermethylation of FHIT promoter region was significantly increased in breast cancer patients compared to bengin breast disease patients. The Odd ?s ratio (95%CI) of development of breast cancer in individuals with FHIT promoter hypermethylation (MM) was 11.0 (1.22-250.8). There were also significant associations between FHIT promoter hypermethylation and estrogen, progesterone receptors negativity, tumor stage and nodal involvment in breast cancer pateints. CONCLUSIONS: Our results support an association between FHIT promotor hypermethylation and development of breast cancer in Egyptian breast cancer patients. FHIT promoter hypermethylation is associated with some poor prognostic features of breast cancer.