| 1. |
- Ademuyiwa, Adesoji O., et al.
(författare)
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Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
- 2016
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Ingår i: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally.Methods: Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression.Results: This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed.Conclusions: Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas.
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| 2. |
- Ghazy, Ramy Mohamed, et al.
(författare)
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Quality of life among health care workers in Arab countries 2 years after COVID-19 pandemic
- 2022
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Ingår i: Frontiers in Public Health. - : Frontiers Media SA. - 2296-2565. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Assessment of the quality of life (QoL) among healthcare workers (HCWs) is vital for better healthcare and is an essential indicator for competent health service delivery. Since the coronavirus disease 2019 (COVID-19) pandemic strike, the frontline position of HCWs subjected them to tremendous mental and psychological burden with a high risk of virus acquisition. Aim: This study evaluated the QoL and its influencing factors among HCWs residing in the Arab countries. Methods: This was a cross-sectional study using a self-administered online questionnaire based on the World Health Organization QoL-BREF instrument with additional questions related to COVID-19. The study was conducted in three different languages (Arabic, English, and French) across 19 Arab countries between February 22 and March 24, 2022. Results: A total of 3,170 HCWs were included in the survey. The majority were females (75.3%), aged 18–40 years (76.4%), urban residents (90.4%), married (54.5%), and were living in middle-income countries (72.0%). The mean scores of general health and general QoL were 3.7 ± 1.0 and 3.7 ± 0.9, respectively. Those who attained average physical, psychological, social, and environmental QoL were 40.8, 15.4, 26.2, and 22.3%, respectively. The income per capita and country income affected the mean scores of all QoL domains. Previous COVID-19 infection, having relatives who died of COVID-19, and being vaccinated against COVID-19 significantly affected the mean scores of different domains. Conclusion: A large proportion of the Arab HCWs evaluated in this study had an overall poor QoL. More attention should be directed to this vulnerable group to ensure their productivity and service provision.
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| 3. |
- Abouzid, Mohamed, et al.
(författare)
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Investigating the current environmental situation in the Middle East and North Africa (MENA) region during the third wave of COVID-19 pandemic : urban vs. rural context
- 2022
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Ingår i: BMC Public Health. - : Springer Nature. - 1471-2458. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundCoronavirus 2019 (COVID-19) pandemic led to a massive global socio-economic tragedy that has impacted the ecosystem. This paper aims to contextualize urban and rural environmental situations during the COVID-19 pandemic in the Middle East and North Africa (MENA) Region.ResultsAn online survey was conducted, 6770 participants were included in the final analysis, and 64% were females. The majority of the participants were urban citizens (74%). Over 50% of the urban residents significantly (p < 0.001) reported a reduction in noise, gathering in tourist areas, and gathering in malls and restaurants. Concerning the pollutants, most urban and rural areas have reported an increase in masks thrown in streets (69.49% vs. 73.22%, resp.; p = 0.003). Plastic bags and hospital waste also increased significantly with the same p-value of < 0.001 in urban areas compared with rural ones. The multifactorial logistic model for urban resident predictors achieved acceptable discrimination (AUROC = 0.633) according to age, crowdedness, noise and few pollutants.ConclusionThe COVID-19 pandemic had a beneficial impact on the environment and at the same time, various challenges regarding plastic and medical wastes are rising which requires environmental interventions.
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| 4. |
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- 2019
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Tidskriftsartikel (refereegranskat)
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| 5. |
- Elkoumy, Ahmed, et al.
(författare)
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ACURATE neo2 Transcatheter aortic valve implantation without balloon aortic valvuloplasty : direct ACURATE neo2
- 2024
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Ingår i: International Journal of Cardiology. - 0167-5273 .- 1874-1754. ; 400
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Tidskriftsartikel (refereegranskat)abstract
- Background: ACURATE neo2 (Neo2) implantation is performed after systematic Balloon Aortic Valvuloplasty (BAV) in most patients. No reports exist about the feasibility and safety of direct Neo2 transcatheter aortic valve implantation (TAVI) in comparison to the standard practice. Aim: We aimed to identify the patients' baseline anatomical characteristics, procedural, and early post-procedural outcomes in patients treated using Neo2 with and without BAV. Methodology: This is a retrospective multicentre analysis of 499 patients with severe aortic stenosis who underwent TAVI using Neo2. The comparison was done according to the performance or omission of BAV. Echocardiography and computed tomography were analysed by an independent Core Lab. Propensity score matching (PSM) was performed based on the annular diameter and AV calcium volume, which identified 84 matched pairs. Results: Among the cohort included, 391 (78%) patients received BAV (BAV-yes) and 108 (22%) were not attempted (BAV-no or Direct TAVI). Patients in BAV-no cohort had smaller annular diameter (22.6 vs 23.4 mm; p < 0.001) and lower calcium volume (163 vs 581 mm3; p < 0.001) compared to BAV-yes cohort. In the matched cohort, VARC-3 device technical success was similar (95%) and all other outcome measures were statistically comparable between cohorts. Conclusion: Direct TAVI using ACURATEneo2 without pre-TAVI balloon aortic valvuloplasty in patients with mild or less valve calcifications might be feasible and associated with comparable early outcomes compared to patients with similar anatomical features undergoing systematic balloon valvuloplasty.
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| 6. |
- Elkoumy, Ahmed, et al.
(författare)
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Core Lab Adjudication of the ACURATE neo2 Hemodynamic Performance Using Computed-Tomography-Corrected Left Ventricular Outflow Tract Area
- 2022
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Ingår i: Journal of Clinical Medicine. - : MDPI AG. - 2077-0383. ; 11:20, s. 1-12
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Tidskriftsartikel (refereegranskat)abstract
- (1) Background: Hemodynamic assessment of prosthetic heart valves using conventional 2D transthoracic Echocardiography-Doppler (2D-TTE) has limitations. Of those, left ventricular outflow tract (LVOT) area measurement is one of the major limitations of the continuity equation, which assumes a circular LVOT. (2) Methods: This study comprised 258 patients with severe aortic stenosis (AS), who were treated with the ACURATE neo2. The LVOT area and its dependent Doppler-derived parameters, including effective orifice area (EOA) and stroke volume (SV), in addition to their indexed values, were calculated from post-TAVI 2D-TTE. In addition, the 3D-LVOT area from pre-procedural MDCT scans was obtained and used to calculate corrected Doppler-derived parameters. The incidence rates of prosthesis patient mismatch (PPM) were compared between the 2D-TTE and MDCT-based methods (3) Results: The main results show that the 2D-TTE measured LVOT is significantly smaller than 3D-MDCT (350.4 ± 62.04 mm2 vs. 405.22 ± 81.32 mm2) (95% Credible interval (CrI) of differences: −55.15, −36.09), which resulted in smaller EOA (2.25 ± 0.59 vs. 2.58 ± 0.63 cm2) (Beta = −0.642 (95%CrI of differences: −0.85, −0.43), and lower SV (73.88 ± 21.41 vs. 84.47 ± 22.66 mL), (Beta = −7.29 (95% CrI: −14.45, −0.14)), respectively. PPM incidence appears more frequent with 2D-TTE- than 3D-MDCT-corrected measurements (based on the EOAi) 8.52% vs. 2.32%, respectively. In addition, significant differences regarding the EOA among the three valve sizes (S, M and L) were seen only with the MDCT, but not on 2D-TTE. (4) Conclusions: The corrected continuity equation by combining the 3D-LVOT area from MDCT with the TTE Doppler parameters might provide a more accurate assessment of hemodynamic parameters and PPM diagnosis in patients treated with TAVI. The ACURATE neo2 THV has a large EOA and low incidence of PPM using the 3D-corrected LVOT area than on 2D-TTE. These findings need further confirmation on long-term follow-up and in other studies.
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| 7. |
- Hassanin, Abdallah A., et al.
(författare)
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Emergence, evolution, and vaccine production approaches of SARS-CoV-2 virus : benefits of getting vaccinated and common questions
- 2022
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Ingår i: Saudi Journal of Biological Sciences. - : Elsevier. - 1319-562X. ; 29:4, s. 1981-1997
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Forskningsöversikt (refereegranskat)abstract
- The emergence of coronavirus disease 2019 (COVID-19) pandemic in Wuhan city, China at the end of 2019 made it urgent to identify the origin of the causal pathogen and its molecular evolution, to appropriately design an effective vaccine. This study analyzes the evolutionary background of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or SARS-2) in accordance with its close relative SARS-CoV (SARS-1), which was emerged in 2002. A comparative genomic and proteomic study was conducted on SARS-2, SARS-1, and Middle East respiratory syndrome coronavirus (MERS), which was emerged in 2012. In silico analysis inferred the genetic variability among the tested viruses. The SARS-1 genome harbored 11 genes encoding 12 proteins, while SARS-2 genome contained only 10 genes encoding for 10 proteins. MERS genome contained 11 genes encoding 11 proteins. The analysis also revealed a slight variation in the whole genome size of SARS-2 comparing to its siblings resulting from sequential insertions and deletions (indels) throughout the viral genome particularly ORF1AB, spike, ORF10 and ORF8. The effective indels were observed in the gene encoding the spike protein that is responsible for viral attachment to the angiotensin-converting enzyme 2 (ACE2) cell receptor and initiating infection. These indels are responsible for the newly emerging COVID-19 variants αCoV, βCoV, γCoV and δCoV. Nowadays, few effective COVID-19 vaccines developed based on spike (S) glycoprotein were approved and become available worldwide. Currently available vaccines can relatively prevent the spread of COVID-19 and suppress the disease. The traditional (killed or attenuated virus vaccine and antibody-based vaccine) and innovated vaccine production technologies (RNA- and DNA-based vaccines and viral vectors) are summarized in this review. We finally highlight the most common questions related to COVID-19 disease and the benefits of getting vaccinated.
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| 8. |
- Shaaban, Ramy, et al.
(författare)
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COVID-19 Vaccine Acceptance among Social Media Users : A Content Analysis, Multi-Continent Study
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 19:9
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Tidskriftsartikel (refereegranskat)abstract
- Vaccine hesitancy (VH) is defined as a delayed in acceptance or refusal of vaccines despite availability of vaccination services. This multinational study examined user interaction with social media about COVID-19 vaccination. The study analyzed social media comments in 24 countries from five continents. In total, 5856 responses were analyzed; 83.5% of comments were from Facebook, while 16.5% were from Twitter. In Facebook, the overall vaccine acceptance was 40.3%; the lowest acceptance rates were evident in Jordan (8.5%), Oman (15.0%), Senegal (20.0%) and Morocco (20.7%) and the continental acceptance rate was the lowest in North America 22.6%. In Twitter, the overall acceptance rate was (41.5%); the lowest acceptance rate was found in Oman (14.3%), followed by USA (20.5%), and UK (23.3%) and the continental acceptance rate was the lowest in North America (20.5%), and Europe (29.7%). The differences in vaccine acceptance across countries and continents in Facebook and Twitter were statistically significant. Regarding the tone of the comments, in Facebook, countries that had the highest number of serious tone comments were Sweden (90.9%), USA (61.3%), and Thailand (58.8%). At continent level, serious comments were the highest in Asia (58.4%), followed by Africa (46.2%) and South America (46.2%). In Twitter, the highest serious tone was reported in Egypt (72.2%) while at continental level, the highest proportion of serious comments was observed in Asia (59.7%), followed by Europe (46.5%). The differences in tone across countries and continents in Facebook and Twitter and were statistically significant. There was a significant association between the tone and the position of comments. We concluded that the overall vaccine acceptance in social media was relatively low and varied across the studied countries and continents. Consequently, more in-depth studies are required to address causes of such VH and combat infodemics.
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| 9. |
- Abbas, Ashraf H., et al.
(författare)
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Aesthetic Outcome After Reconstruction of Complex SoftTissue Defects with Free Antero-Lateral Thigh Flap UsingSimple Equipment
- 2015
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Ingår i: Journal of surgery. - : Science publishing group. - 2330-0914 .- 2330-0930. ; 3:2-1, s. 36-41
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Tidskriftsartikel (refereegranskat)abstract
- Aim: We aimed to assess the aesthetic outcome of surgical reconstruction by free ALT flap using binocular single-refraction magnifying glasses and a modified post- operative surveillance protocol. Methods: 16 patients were operated for free antero-lateral thigh flap to reconstruct complex soft tissue defects with a close clinical follow up protocol for post operative care depending on the attending personnel in the Plastic surgery unit, Suez Canal University hospital, Ismailia, Egypt. Aesthetic outcome was assessed using a questionnaire based on Posch et al. 2005, including the following items colour, contour, presence of hair, overall appearance and donor site scar. Results: The patients’ assessed aesthetic outcome was acceptable in majority of the cases; median score was 4 for all assessed items. Complete flap loss occurred in one case, other complications as arterial thrombosis and hematomas and infection were detected and managed accordingly with flap salvage in the 3 complicated cases. Conclusion: The result suggests that the proposed protocol is sufficient as an alternative. The aesthetic outcome assessed by the patient and the failure rate was in line with other studies.
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| 10. |
- Abdelrahman, Islam, et al.
(författare)
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A prospective randomized cost billing comparison of local fasciocutaneous perforator versus free Gracilis flap reconstruction for lower limb in a developing economy
- 2016
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Ingår i: Journal of Plastic, Reconstructive & Aesthetic Surgery. - : Elsevier. - 1748-6815 .- 1878-0539. ; 69:8, s. 1121-1127
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Tidskriftsartikel (refereegranskat)abstract
- Distal half leg complex wounds are usually a formidable problem that necessitates either local or free flap coverage. The aim of this study was to compare cost billing charges in free Gracilis flap (fGF) and local fasciocutaneous perforator flap (lFPF) in reconstructing complex soft tissue leg and foot defects. Patients and methods: Thirty consecutive adult (amp;gt; 15-year-old) patients with soft tissue defects in the leg and/or foot requiring tissue coverage with a flap in the period between 2012 and 2015 were randomly assigned (block randomization) to either an fGF or lFPF procedure. The outcome measures addressed were total billed charges costs, perioperative billed charges cost, partial or complete flap loss, length of hospital stay, inpatient postsurgical care duration, complications, operating time and number of operative scrub staff. Results: One patient suffered from complete flap loss in each group. Reconstruction with lFPF showed total lower billed charges costs by 62% (2509 USD) (p amp;lt; 0.001) and perioperative billed charges cost by 54% (779 USD) (p amp;lt; 0.001), and shorter total hospital stay (36.5 days; p amp;lt; 0.001), inpatient postsurgical care duration (6.4 days; p amp;lt; 0.001), operating time (4.3 h; p amp;lt; 0.001) and fewer scrub staff (2.2 persons; p amp;lt; 0.001). Conclusion: These results suggest that neither flap is totally superior to the other; the choice should instead be based on the outcome sought and logistics. lFPF requires lower billed charges cost and resource use and saves operative time and personnel and reduces length of hospital stay. Our approach changed towards using perforator flaps in medium-sized defects, keeping the free flap option for larger defects. (C) 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
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