Medical education and the epidemics: How educational technology responded.

The global disruption created by the Coronavirus Disease 2019 (COVID-19) pandemic in medical education and healthcare institutions is unparalleled. Consequently, it is essential to evaluate the usability of forms of educational technology and to identify their viability and suitability for medical education. The objective of the investigation was to present an assessment of the state of medical education during the COVID-19 epidemic and to identify the obstacles faced by educators while introducing online learning systems for medical students. Two cross-sectional surveys were conducted with 200 medical students and 75 staff members from Saudi Arabia's University of Health. A descriptive method was used to focus on the mechanisms of analysis, foresight, and comprehension of reality. The most significant findings were the obstacles posed by instructors' most urgent requirements for educational technology training and its applications in order to activate distance education in medical education. In addition to a detailed description of the academic and technological concerns and obstacles encountered by students and faculty of health colleges during the pandemic, this report includes a discussion of the pandemic itself. Several prospective recommendations for the use of online and blended learning in health colleges post-pandemic were also made. Additionally, the requirement to activate learning via virtual professional learning groups.

La perturbation mondiale créée par la pandémie de maladie à coronavirus 2019 (COVID-19) dans les établissements d'enseignement médical et de soins de santé est sans précédent. Par conséquent, il est essentiel d'évaluer l'utilisabilité des formes de technologie éducative et d'identifier leur viabilité et leur adéquation à l'enseignement médical. L'objectif de l'enquête était de présenter une évaluation de l'état de l'enseignement médical pendant l'épidémie de COVID-19 et d'identifier les obstacles rencontrés par les éducateurs lors de l'introduction de systèmes d'apprentissage en ligne pour les étudiants en médecine. Deux enquêtes transversales ont été menées auprès de 200 étudiants en médecine et de 75 membres du personnel de l'Université de la Santé d'Arabie Saoudite. Une méthode descriptive a été utilisée pour se concentrer sur les mécanismes d'analyse, de prospective et de compréhension de la réalité. Les résultats les plus significatifs ont été les obstacles posés par les besoins les plus urgents des instructeurs en matière de formation en technologie éducative et ses applications afin d'activer l'enseignement à distance en médecine. éducation. En plus d'une description détaillée des préoccupations et des obstacles académiques et technologiques rencontrés par les étudiants et les professeurs des collèges de santé pendant la pandémie, ce rapport comprend une discussion sur la pandémie elle-même. Plusieurs recommandations prospectives concernant l'utilisation de l'apprentissage en ligne et mixte dans les établissements de santé après la pandémie ont également été formulées. À cela s'ajoute l'obligation d'activer l'apprentissage via des groupes d'apprentissage professionnel virtuels.

COVID-19 Severity in Patients With Apical Periodontitis: A Case Control Study.

OBJECTIVES: Apical periodontitis (AP) has been associated with systemic inflammatory biomarkers that have also been associated with COVID-19 severity. This study was designed to test the hypothesis that the presence of apical periodontitis could be associated with increased risk of COVID-19 complications. METHODS: A case control study (N = 949) was performed using the medical and dental records of patients diagnosed with COVID-19 in the State of Qatar between March 2020 and February 2021. Cases comprised COVID-19 patients (n = 63) who experienced complications (death, intensive care unit admissions, mechanical ventilation), and controls were COVID-19 patients (n = 886) who recovered without such complications. The presence of periapical apical periodontitis was assessed on the radiographic records taken prior to COVID-19 infection. Associations between apical periodontitis and COVID 19 complications were analysed using logistic regression models adjusted for demographic and medical factors. Blood biomarkers were assessed in both groups and compared using the Kruskal-Wallis test. RESULTS: COVID-19 complications were found to be associated with the presence of apical periodontitis (adjusted odds ratio = 2.72; 95% CI, 1.30-5.68; P = .008). Blood analyses revealed that COVID-19 patients with apical periodontitis had higher levels of white blood cells and haemoglobin A1c than the patients without apical periodontitis. CONCLUSIONS: The presence of apical periodontitis could be associated with increased risk of COVID-19 complications.

An In-Depth Examination of the Natural Radiation and Radioactive Dangers Associated with Regularly Used Medicinal Herbs.

The specific activity of U-238 and Th-232, as well as K-40 radionuclides, in twenty-nine investigated medicinal herbs used in Egypt has been measured using a high-purity germanium (HP Ge) detector. The measured values ranged from the BDL to 20.71 ± 1.52 with a mean of 7.25 ± 0.54 (Bq kg-1) for uranium-238, from the BDL to 29.35 ± 1.33 with a mean of 7.78 ± 0.633 (Bq kg-1) for thorium-232, and from 172 ± 5.85 to 1181.2 ± 25.5 with a mean of 471.4 ± 11.33 (Bq kg-1) for potassium-40. Individual herbs with the highest activity levels were found to be 20.71 ± 1.52 (Bq kg-1) for uranium-238 (H4, Thyme herb), 29.35 ± 1.33 (Bq kg-1) for thorium-232 (H20, Cinnamon), and 1181.2 ± 25.5 (Bq kg-1) for potassium-40 (H24, Worm-wood). (AACED) Ingestion-related effective doses over the course of a year of uranium-238 and thorium-232, as well as potassium-40 estimated from measured activity concentrations, are 0.002304 ± 0.00009 (minimum), 0.50869 ± 0.0002 (maximum), and 0.0373 ± 0.0004 (average)(mSv/yr). Radium equivalent activity (Raeq), annual gonadal dose equivalent (AGDE), absorbed gamma dose rate (Doutdoor, Dindoor), gamma representative level index (I), annual effective dose (AEDtotal), external and internal hazard index (Hex, Hin), and excess lifetime cancer risk were determined in medicinal plants (ELCR). The radiological hazards assessment revealed that the investigated plant species have natural radioactivity levels that are well within the internationally recommended limit. This is the first time that the natural radioactivity of therapeutic plants has been measured in Egypt. In addition, no artificial radionuclide (for example, 137Cs) was discovered in any of the samples. Therefore, the current findings are intended to serve as the foundation for establishing a standard safety and guideline for using these therapeutic plants in Egypt.

Removal of Uranium-238, Thorium-232, and Potassium-40 from Wastewater via Adsorption on Multiwalled Carbon Nanotubes.

The optimum conditions for the removal of uranium-238, thorium-232, and potassium-40 from wastewater and the discharge of nuclear facilities using multiwalled carbon nanotubes (CNTs) are described. The adsorption mechanism is mainly attributed to chemical interactions between the metal ions and surface functional groups of the CNTs. Batch adsorption experiments are carried out in order to study the effect of different parameters such as pH, contact time, initial metal ion concentration, adsorbent dose, and temperatures. Maximum metal removal (>98%) from solutions containing 20-120 Bq/L metal ions is achieved using a contact time of 15 min, a pH of 6.0, and 10 mg/L CNTs. The effect of temperature on the kinetics and equilibrium of adsorption on CNT particles is examined. Consistent with an exothermic reaction, an increase in the temperature resulted in an increase in the adsorption rate. Langmuir, Freundlich, and Dubinin-Radushkevich isotherms are applied to the data obtained at various temperatures. The Langmuir adsorption model is the best for data interpretations. The kinetics of adsorption reveals a pseudo-second-order mechanism. Thermodynamic parameters at 293 K (ΔG°, ΔH°, and ΔS°) for U-238, Th-232, and K-40 are -14590.7 kJ/mol, -6.66 kJ/mol, and 26.47 J/(mol K), -96,96.5 kJ/mol, -2.48 kJ/mol, and 14.17 J/(mol K), and -3922.09 kJ/mol, -1.32 kJ/mol, and 6.12 J/(mol K), respectively.

Interaction between cognitive styles and genders when using virtual laboratories and its influence on students of health college's laboratory skills and cognitive load during the Corona pandemic.

This study examined the interaction between cognitive style-gender within Virtual Laboratories (VL) and its influence on students of health college's Laboratory Skills (LS) and Cognitive Load (CL) during the Corona pandemic. This research method is a combination of quasi-experimental research and survey research; consisting of two male and two female experimental groups (contemplative and impulsive). Each group had 20 students from General Health colleges. In the third level, with the microbiological course, eight experiments were studied by a Virtual laboratory (Praxilabs) during the eLearning study in 2020's first semester. Results showed that VL-using Students of General Health colleges studying microbiology had better CL and LS, besides significantly distinguishing between males and females using VLs in CL and LS where males benefited more. Also, a significant difference was established between CS (contemplative/impulsive) VL-using students in CL and LS to the benefit of the contemplative cognitive style. There LS significantly differ due to gender-CS interaction; however, CL does not have any differences because of this interaction.

Association between periodontitis and severity of COVID-19 infection: A case-control study.

AIM: COVID-19 is associated with an exacerbated inflammatory response that can result in fatal outcomes. Systemic inflammation is also a main characteristic of periodontitis. Therefore, we investigated the association of periodontitis with COVID-19 complications. MATERIALS AND METHODS: A case-control study was performed using the national electronic health records of the State of Qatar between February and July 2020. Cases were defined as patients who suffered COVID-19 complications (death, ICU admissions or assisted ventilation), and controls were COVID-19 patients discharged without major complications. Periodontal conditions were assessed using dental radiographs from the same database. Associations between periodontitis and COVID 19 complications were analysed using logistic regression models adjusted for demographic, medical and behaviour factors. RESULTS: In total, 568 patients were included. After adjusting for potential confounders, periodontitis was associated with COVID-19 complication including death (OR = 8.81, 95% CI 1.00-77.7), ICU admission (OR = 3.54, 95% CI 1.39-9.05) and need for assisted ventilation (OR = 4.57, 95% CI 1.19-17.4). Similarly, blood levels of white blood cells, D-dimer and C Reactive Protein were significantly higher in COVID-19 patients with periodontitis. CONCLUSION: Periodontitis was associated with higher risk of ICU admission, need for assisted ventilation and death of COVID-19 patients, and with increased blood levels of biomarkers linked to worse disease outcomes.

Six-year multicenter study on short-term peripheral venous catheters-related bloodstream infection rates in 246 intensive units of 83 hospitals in 52 cities of 14 countries of Middle East: Bahrain, Egypt, Iran, Jordan, Kingdom of Saudi Arabia, Kuwait, Lebanon, Morocco, Pakistan, Palestine, Sudan, Tunisia, Turkey, and United Arab Emirates-International Nosocomial Infection Control Consortium (INICC) findings.

BACKGROUND: Short-term peripheral venous catheters-related bloodstream infections (PVCR-BSIs) rates have not been systematically studied, and data on their incidence by number of device-days is not available. METHODS: Prospective, surveillance study on PVCR-BSI conducted from September 1st, 2013 to 31st Mays, 2019 in 246 intensive care units (ICUs), members of the International Nosocomial Infection Control Consortium (INICC), from 83 hospitals in 52 cities of 14 countries in the Middle East (Bahrain, Egypt, Iran, Jordan, Kingdom of Saudi Arabia, Kuwait, Lebanon, Morocco, Pakistan, Palestine, Sudan, Tunisia, Turkey, and United Arab Emirates). We applied U.S. RESULTS: We followed 31,083 ICU patients for 189,834 bed-days and 202,375 short term peripheral venous catheter (PVC)-days. We identified 470 PVCR-BSIs, amounting to a rate of 2.32/1000 PVC-days. Mortality in patients with PVC but without PVCR-BSI was 10.38%, and 29.36% in patients with PVC and PVCR-BSI. The mean length of stay in patients with PVC but without PVCR-BSI was 5.94 days, and 16.84 days in patients with PVC and PVCR-BSI. The microorganism profile showed 55.2 % of gram-positive bacteria, with Coagulase-negative Staphylococci (31%) and Staphylococcus aureus (14%) being the predominant ones. Gram-negative bacteria accounted for 39% of cases, and included: Escherichia coli (7%), Klebsiella pneumoniae (8%), Pseudomonas aeruginosa (5%), Enterobacter spp. (3%), and others (29.9%), such as Serratia marcescens. CONCLUSIONS: PVCR-BSI rates found in our ICUs were much higher than rates published from USA, Australia, and Italy. Infection prevention programs must be implemented to reduce the incidence of PVCR-BSIs.

Environmental assessment of radionuclides levels and some heavy metals pollution along Gulf of Suez, Egypt.

This work aims to evaluate radioactivity levels of 238U (226Ra), 232Th(228Ra), and 40K and the associated radiological hazard indices, as well as to assess the current status and concentrations of heavy metals along the coastline of the Gulf of Suez, in order to identify potential sources of contamination and to construct radioactivity baseline for this area. Measurements of the activity concentrations of 238U(226Ra), 232Th(228Ra), and 40K in Bq kg-1 of the collected samples were carried out using high-purity germanium (HPGe) detector. Heavy metals in seawater, shore sediment, and algae samples were determined using ICP-OES. The average activity concentrations of 238U(226Ra), 232Th(228Ra), and 40K were found to be 13.79 ± 0.75, 14.57 ± 1.15, and 128.9 ± 4.15 Bq kg-1, respectively. The radiological hazard indices of absorbed dose rate in nGy h-1 (D), annual effective dose rate in mSv y-1, AED, radium equivalent activity in Bq (Raeq), external and internal hazard indices (Hex, Hin), and cancer risk factor were calculated and compared with the worldwide averages. The distribution patterns of annual effective dose (AED) at the Suez Gulf showed that the south east of the Gulf is characterized by higher AED. Water quality parameters (water temperature, salinity, pH, DO, and Eh) reveal that Suez Gulf was undoubtedly affected by the rate of the human activities. Heavy metal concentrations in shore sediments showed some variation within the study area and followed the following order: Fe > Mn > Zn > Al > B > Co > Ni > Pb > V > Cr > Mo > Cu > Cd. Furthermore, heavy metal concentrations indicated that northern part of the Gulf contains the highest levels of these metals compared to the southern one.

Impact of the International Nosocomial Infection Control Consortium (INICC)'s multidimensional approach on rates of ventilator-associated pneumonia in intensive care units in 22 hospitals of 14 cities of the Kingdom of Saudi Arabia.

BACKGROUND: To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and use of INICC Surveillance Online System (ISOS) on ventilator-associated pneumonia (VAP) rates in Saudi Arabia from September 2013 to February 2017. METHODS: A multicenter, prospective, before-after surveillance study on 14,961 patients in 37 intensive care units (ICUs) of 22 hospitals. During baseline, we performed outcome surveillance of VAP applying the definitions of the CDC/NHSN. During intervention, we implemented the IMA and the ISOS, which included: (1) a bundle of infection prevention practice interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback on VAP rates and consequences and (6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using generalized linear mixed models to estimate the effect of intervention. RESULTS: The baseline rate of 7.84 VAPs per 1000 mechanical-ventilator (MV)-days-with 20,927 MV-days and 164 VAPs-, was reduced to 4.74 VAPs per 1000 MV-days-with 118,929 MV-days and 771 VAPs-, accounting for a 39% rate reduction (IDR 0.61; 95% CI 0.5-0.7; P 0.001). CONCLUSIONS: Implementing the IMA was associated with significant reductions in VAP rates in ICUs of Saudi Arabia.

Prospective multicentre study in intensive care units in five cities from the Kingdom of Saudi Arabia: Impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach on rates of central line-associated bloodstream infection.

OBJECTIVE: To analyse the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and INICC Surveillance Online System (ISOS) on central line-associated bloodstream infection (CLABSI) rates in five intensive care units (ICUs) from October 2013 to September 2015. DESIGN: Prospective, before-after surveillance study of 3769 patients hospitalised in four adult ICUs and one paediatric ICU in five hospitals in five cities. During baseline, we performed outcome and process surveillance of CLABSI applying CDC/NHSN definitions. During intervention, we implemented IMA and ISOS, which included: (1) a bundle of infection prevention practice interventions; (2) education; (3) outcome surveillance; (4) process surveillance; (5) feedback on CLABSI rates and consequences; and (6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed. RESULTS: During baseline, 4468 central line (CL) days and 31 CLABSIs were recorded, accounting for 6.9 CLABSIs per 1000 CL-days. During intervention, 12,027 CL-days and 37 CLABSIs were recorded, accounting for 3.1 CLABSIs per 1000 CL-days. The CLABSI rate was reduced by 56% (incidence-density rate, 0.44; 95% confidence interval, 0.28-0.72; P = 0.001). CONCLUSIONS: Implementing IMA through ISOS was associated with a significant reduction in the CLABSI rate in the ICUs of Saudi Arabia.

Natural radioactivity and radiological hazard assessment of Egyptian oil ashes.

Oil fly and boiler ash samples were collected from the four major Egyptian power plants in order to determine their natural radioactivity. Secular equilibrium between (238)U and (232)Th and their decay products is significantly disturbed in oil ash samples. The (226)Ra/(238)U ratios were between 440 and 1993 with an average value of 801, indicating that the concentrations of daughters (226)Ra were very high compared to the parent (238)U in the oil ash samples. While, the average ratios for (210)Pb/(226)Ra in most samples were 1.19 ± 0.05, indicating a secular equilibrium in the (226)Ra-(210)Pb sub series. The natural radioactivity due to (238)U and (232)Th was found to be negligible. While the activity concentrations of (226)Ra ranged from 3205 to 12,320 Bq kg(-1) with an average value of 9284 Bq kg(-1), (210)Pb ranged from 5960 to 13,930 Bq kg(-1) with an average value of 11,513 Bq kg(-1). The results are compared with the reported data from other countries. The average value of radium equivalent activity was 9308 ± 2729 Bq kg(-1), while the external and internal hazard indexes were found to be 25 ± 7 and 50 ± 15, respectively. All the studied radiological parameters were higher than the recommended limit by the IAEA in all ash samples.

Screening for the hepatitis C virus in some dental clinics in Alexandria, Egypt.

BACKGROUND/OBJECTIVES: Individuals can be exposed to the hepatitis C virus (HCV) infection through inadequately or improperly sterilized medical or dental equipment. The aim of this study was to detect HCV RNA in the dental setting in Alexandria, Egypt. MATERIALS AND METHODS: The study included 100 samples collected from five dental clinics (A-E) in Alexandria. The samples were collected from critical, semicritical, and noncritical instruments during different periods of the day (morning, mid-day, end of the day). Samples were subjected to a reverse transcriptase-PCR for the detection of HCV RNA. RESULTS: HCV RNA was detected in 18% (18 out of 100) of the instrument samples tested. Two positive HCV RNA samples were collected from semicritical instruments in clinic B, whereas 16 positive HCV RNA samples were collected from clinic D (eight samples from critical, six samples from semicritical, and two samples from noncritical instruments). There was a statistically significant difference between clinics B and D in terms of the samples collected in the morning and those collected at the end of the day. CONCLUSION AND RECOMMENDATIONS: HCV RNA as detected by PCR was found in a considerable percent of instruments' samples (18%). Most of the positive HCV RNA samples (16 out of 18 samples) obtained from instruments were among those collected from clinic D. This clinic used only glutaraldehyde as a method of sterilization. Therefore, proper infection control measures, including sterilization and disinfection should be strictly adopted.