Search results for: Dina Mahmoud Hammouri

Authors: Adem Rama, Rabiha Seboussi, Mahmoud Muhamadin, Sultan Alzarooni, Fatima Mohamed, Khuloud Al Ali

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To assess public health hazards associated with the occurrence of Antibiotics and AFM1 residues in UHT milk, a survey was carried out in Sharjah, UAE. In the present study, a total of 42 UHT milk samples analyzed were from different commercial brands manufactured in industrial dairy units in the UAE and from foreign producers. Milk samples were collected for four months (January to April 2020). The occurrence and concentration range of Antibiotics (Streptomycin and Gentamycin) and AFM1 in the samples were investigated by applying the ELISA method. According to the methodology used in this study, in total, 2 (5%) out of 42(95%) samples tested positive on the presence of AFM1. While, 1(2.4%) out of 41(97.6%) positive samples were found to contain Streptomycin and Gentamycin, respectively. The positive incidence of AFM1 in the UHT milk samples ranged from 58.8 to 1074 µg/L, for Streptomycin from up to 1004 µg/L, and Gentamycin up to 6909 µg/L. There were no positive samples found in locally produced UHT milk. AFM1 and antibiotic levels in positive samples UHT milk samples exceeded the maximum tolerable limits as set by the European Union - EC guidelines/standards. These levels in the samples show a presence of contaminants that might constitute a human health risk in Sharjah. The results of this study imply that more emphasis should be given to the routine inspection of milk and dairy products in the Sharjah region.

Keywords: milk, contaminant residues, ELISA, public health, Sharjah

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Authors: Yelin Zhao, Xinxiu Li, Martin Smelik, Oleg Sysoev, Firoj Mahmud, Dina Mansour Aly, Mikael Benson

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Background: Early diagnosis of pancreatic cancer is clinically challenging due to vague, or no symptoms, and lack of biomarkers. Polygenic risk score (PRS) scores may provide a valuable tool to assess increased or decreased risk of PC. This study aimed to develop such PRS by filtering genetic variants identified by GWAS using transcriptional programs identified by single-cell RNA sequencing (scRNA-seq). Methods: ScRNA-seq data from 24 pancreatic ductal adenocarcinoma (PDAC) tumor samples and 11 normal pancreases were analyzed to identify differentially expressed genes (DEGs) in in tumor and microenvironment cell types compared to healthy tissues. Pathway analysis showed that the DEGs were enriched for hundreds of significant pathways. These were clustered into 40 “programs” based on gene similarity, using the Jaccard index. Published genetic variants associated with PDAC were mapped to each program to generate program PRSs (pPRSs). These pPRSs, along with five previously published PRSs (PGS000083, PGS000725, PGS000663, PGS000159, and PGS002264), were evaluated in a European-origin population from the UK Biobank, consisting of 1,310 PDAC participants and 407,473 non-pancreatic cancer participants. Stepwise Cox regression analysis was performed to determine associations between pPRSs with the development of PC, with adjustments of sex and principal components of genetic ancestry. Results: The PDAC genetic variants were mapped to 23 programs and were used to generate pPRSs for these programs. Four distinct pPRSs (P1, P6, P11, and P16) and two published PRSs (PGS000663 and PGS002264) were significantly associated with an increased risk of developing PC. Among these, P6 exhibited the greatest hazard ratio (adjusted HR[95% CI] = 1.67[1.14-2.45], p = 0.008). In contrast, P10 and P4 were associated with lower risk of developing PC (adjusted HR[95% CI] = 0.58[0.42-0.81], p = 0.001, and adjusted HR[95% CI] = 0.75[0.59-0.96], p = 0.019). By comparison, two of the five published PRS exhibited an association with PDAC onset with HR (PGS000663: adjusted HR[95% CI] = 1.24[1.14-1.35], p < 0.001 and PGS002264: adjusted HR[95% CI] = 1.14[1.07-1.22], p < 0.001). Conclusion: Compared to published PRSs, scRNA-seq-based pPRSs may be used not only to assess increased but also decreased risk of PDAC.

Keywords: cox regression, pancreatic cancer, polygenic risk score, scRNA-seq, UK biobank

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Authors: Azhar Jabareen, Mahmoud Huleihel

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BRCA-1 is a multifunctional tumor suppressor, whose expression is activated by the estrogen (E2)-liganded ERα receptor. The activated ERα is a transcriptional factor which activates various genes either by direct binding to the DNA at E2-responsive elements (EREs) and indirectly associated with a range of alternative non-ERE elements. Interference with BRCA-1 expression and/or functions leads to high risk of breast or/and ovarian cancer. Our lab investigated the involvement of Human T-cell leukemia Virus Type 1 (HTLV-1) in breast cancer, since HTLV-1 Tax was found to strongly inhibit BRCA-1 expression. In addition, long exposure of 12-O-tetradecanoylphorbol-13-acetate (TPA), which is one of the stress-inducing agents activated the HTLV-1 promoter. So here the involvement of TPA in breast cancer had been examined by testing the effect of TPA on BRCA-1 and ERE expression. The results showed that TPA activated both BRCA-1 and ERE expression. In the 12 hours TPA activated the tow promoters more than others time, and after 24 hours the level of the tow promoters was decreased. Tax inhibited BRCA-1 expression but did not succeed to inhibit the effect of TPA. Then the activation of the two promoters was not through ERα pathway because TPA had no effect on ERα binding to the two promoters of the BRCA-1 and ERE. Also, the activation was not via nuclear factor kappa B (NF-κB) pathway because when the inhibitory of NF-κB had been added to the TPA, it still activated the tow promoters. However, it seems that 53BP1 may be involved in TPA activation of these promoters because ectopic high expression of 53BP1 significantly reduced the TPA activity. In addition, in the presence of Bisindolylmaleimide-I (BI)- the inhibitor of Protein Kinase C (PKC)- there was no activation for the two promoters, so the PKC is agonized BRCA-1 and ERE activation.

Keywords: BRCA-1, ERE, HTLV-1, TPA

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Authors: Mengying Wang, Xiaohui Wang, Chun Deng, Bei Liu, Changyu Sun, Guangjin Chen, Mahmoud El-Halwagi

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Significant amounts of natural gas hydrates (NGHs) are considered potential new sustainable energy resources in the future. However, common used methods for methane gas recovery from hydrate sediments require high investment but with low gas production efficiency, and may cause potential environment and security problems. Therefore, there is a need for effective gas production from hydrates. The natural gas hydrate production method by CO₂/H₂ replacement coupling steam methane reforming can improve the replacement effect and reduce the cost of gas separation. This paper develops a simulation model of the gas production process integrated with steam reforming and membrane separation. The process parameters (i.e., reactor temperature, pressure, H₂O/CH₄ ratio) and the composition of CO₂ and H₂ in the feed gas are analyzed. Energy analysis is also conducted. Two design scenarios with different composition of CO₂ and H₂ in the feed gas are proposed and evaluated to assess the energy efficiency of the novel system. Results show that when the composition of CO₂ in the feed gas is between 43 % and 72 %, there is a certain composition that can meet the requirement that the flow rate of recycled gas is equal to that of feed gas, so as to ensure that the subsequent production process does not need to add feed gas or discharge recycled gas. The energy efficiency of the CO₂ in feed gas at 43 % and 72 % is greater than 1, and the energy efficiency is relatively higher when the CO₂ mole fraction in feed gas is 72 %.

Keywords: Gas production, hydrate, process integration, steam reforming

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Authors: A. Hegazy, Ahmed Elsayed, Essam El Shenawy, N. Allam, Hala Handal, K. R. Mahmoud

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Highly crystalline, TiO₂ pristine sub-10 nm anatase nanocrystals were fabricated at low temperatures by post hydrothermal treatment of the as-prepared TiO₂ nanoparticles. This treatment resulted in bandgap narrowing and increased photocurrent density value (3.8 mA/cm²) when this material was employed in water splitting systems. The achieved photocurrent values are among the highest reported ones so far for the fabricated nanoparticles at this low temperature. This might be explained by the increased surface defects of the prepared nanoparticles. It resulted in bandgap narrowing that was further investigated using positron annihilation experiments by measuring positron lifetime and Doppler broadening. Besides, homogeneous spherical TiO₂ nanoparticles were synthesized in large diameter and high surface area and the high percentage of (001) facet by sol-gel method using potassium persulfate (K₂S₂O₈) as an oxidizing agent. The fabricated particles exhibited high exposed surface area, high photoactivity and reduced band gap. Enhanced performance for water splitting applications was displayed by formed TiO₂ nanoparticles. Their morphological and structural properties were studied to optimize their synthesis parameters in an attempt to construct more applicable fuel cells in the industry for hydrogen fuel production.

Keywords: positron annihilation, solar energy, TiO2 nanoparticles, water splitting

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Authors: Mahdi Taghipour Masoumi, Ali Abdi Kordani, Mahmoud Nazirizad

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Geosynthetics utilization plays an important role in the construction of highways with no additive layers, such as asphalt concrete or cement concrete, or in a subgrade layer which affects the bearing capacity of unbounded layers. This laboratory experimental study was carried out to evaluate changes in the load bearing capacity of reinforced soil with these materials in highway roadbed with regard to geotextile properties. California Bearing Ratio (CBR) test samples were prepared with two types of soil: Clayey and sandy containing non-reinforced and reinforced soil. The samples comprised three types of geotextiles with different characteristics (150, 200, 300 g/m²) and depths (H= 5, 10, 20, 30, 50, 100 mm), and were grouped into two forms, one-layered and two-layered, based on the sample materials in order to perform defined tests. The results showed that the soil bearing characteristics increased when one layer of geotextile was used in clayey and sandy samples reinforced by geotextile. However, the bearing capacity of the soil, in the presence of a geotextile layer material with depth of more than 30 mm, had no remarkable effect. Furthermore, when the two-layered geotextile was applied in material samples, although it increased the soil resistance, it also showed that through the addition of a number or weights of geotextile into samples, the natural composition of the soil changed and the results are unreliable.

Keywords: reinforced soil, geosynthetics, geotextile, transportation capacity, CBR experiments

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Authors: M. S. Abd El-Sadek, Mahmoud A. Omar, Gharib M. Taha

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Photodegradation of methylene blue in the presence of tin dioxide (SnO₂) nanoparticles under solar light irradiation are known to be an effective photocatalytic process. In this study, pure and silver (Ag) doped tin dioxide (SnO₂) nanoparticles were prepared at calcination temperature (800ºC) by a modified sol-gel method and studied for their photocatalytic activity with methylene blue as a test contaminant. The characterization of undoped and doped SnO₂ photocatalyst was studied by X-rays diffraction patterns (XRD), transmission electron microscopy (TEM), Fourier Transform Infrared Spectroscopy (FT-IR) and Energy Dispersive X-ray Microanalysis (EDX). The catalytic degradation of methylene blue in aqueous media was studied using UV-Vis spectrophotometer to monitor the degradation process by measuring its absorption spectra. The main absorption peak of methylene blue is observed at λ= 664 nm. The change in the percent of silver in the catalyst affects the photoactivity of SnO₂ on the degradation of methylene blue. The photoactivity of pure SnO₂ was found to be a maximum at dose 0.2 gm of the catalyst with 100 ml of 5 ppm methylene blue in the water. Within 210 min of photodegradation (under sunlight) after leaving the reaction for 90 minutes in the dark to avoid the effect of adsorption, the pure SnO₂ at calcination temperature 800ºC exhibited the best photocatalytic degradation with removal percentage of 93.66% on methylene blue degradation under solar light.

Keywords: SnO₂ nanoparticles, methylene blue degradation, photocatalysis, silver doped-SnO₂

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Authors: Eman M. Eissa, Hany M. Hasanin, Mahmoud Abd-Elhamid, S. M. Muyeen, T. Fernando, H. H. C. Iu

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Among all available wind energy conversion systems (WECS), the direct driven permanent magnet synchronous generator integrated with power electronic interfaces is becoming popular due to its capability of extracting optimal energy capture, reduced mechanical stresses, no need to external excitation current, meaning less losses, and more compact size. Simple structure, low maintenance cost; and its decoupling control performance is much less sensitive to the parameter variations of the generator. This paper attempts to present a review of the control and optimization strategies of WECS based on permanent magnet synchronous generator (PMSG) and overview the most recent research trends in this field. The main aims of this review include; the generalized overall WECS starting from turbines, generators, and control strategies including converters, maximum power point tracking (MPPT), ending with DC-link control. The optimization methods of the controller parameters necessary to guarantee the operation of the system efficiently and safely, especially when connected to the power grid are also presented.

Keywords: control and optimization techniques, permanent magnet synchronous generator, variable speed wind turbines, wind energy conversion system

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Authors: Maha Salah, Hanaa Hashem, Mahmoud M. Alsagheir, Mohammed Salah

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Acute respiratory distress syndrome (ARDS) represents a complex clinical syndrome and carries a high risk for mortality. The severity of the clinical course, the uncertainty of the outcome, and the reliance on the full spectrum of critical care resources for treatment mean that the entire health care team is challenged. Researchers and clinicians have investigated the nature of the pathological process and explored treatment options with the goal of improving outcome. Through this application of research to practice, we know that some previous strategies have been ineffective, and innovations in mechanical ventilation, sedation, nutrition, and pharmacological intervention remain important research initiatives. Developed Clinical pathway is multidisciplinary plans of best clinical practice for this specified groups of patients that aid in the coordination and delivery of high quality care. They are a documented sequence of clinical interventions that help a patient to move, progressively through a clinical experience to a desired outcome. Although there is a lot of heterogeneity in patients with ARDS, this suggested developed clinical pathway with alternatives was built depended on a lot of researches and evidence based medicine and nursing practices which may be helping these patients to improve outcomes, quality of life and decrease mortality.

Keywords: acute respiratory distress syndrome (ARDS), clinical pathway, clinical syndrome

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Authors: Michael Aupetit, Mahmoud Al-ismail, Khaled Mohamed

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Cancer is a major public health problem all over the world. Breast cancer has the highest incidence rate over all cancers for women in Qatar making its study a top priority of the country. Human cancer is a dynamic disease that develops over an extended period through the accumulation of a series of genetic alterations. A Darwinian process drives the tumor cells toward higher malignancy growing the branches of a progression tree in the space of genes expression. Although it is not possible to track these genetic alterations dynamically for one patient, it is possible to reconstruct the progression tree from the aggregation of thousands of tumor cells’ genetic profiles from thousands of different patients at different stages of the disease. Analyzing the progression tree is a way to detect pivotal molecular events that drive the malignant evolution and to provide a guide for the development of cancer diagnostics, prognostics and targeted therapeutics. In this work we present the development of a Visual Analytic web platform CanVis enabling users to upload gene-expression data and analyze their progression tree. The server computes the progression tree based on state-of-the-art techniques and allows an interactive visual exploration of this tree and the gene-expression data along its branching structure helping to discover potential driver genes.

Keywords: breast cancer, progression tree, visual analytics, web platform

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Authors: Pritika Ramharack, Mahmoud E. S. Soliman

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The re-emerging Zika virus is an arthropod-borne virus that has been described to have explosive potential as a worldwide pandemic. The initial transmission of the virus was through a mosquito vector, however, evolving modes of transmission has allowed the spread of the disease over continents. The virus already been linked to irreversible chronic central nervous system (CNS) conditions. The concerns of the scientific and clinical community are the consequences of Zika viral mutations, thus suggesting the urgent need for viral inhibitors. There have been large strides in vaccine development against the virus but there are still no FDA-approved drugs available. Rapid rational drug design and discovery research is fundamental in the production of potent inhibitors against the virus that will not just mask the virus, but destroy it completely. In silico drug design allows for this prompt screening of potential leads, thus decreasing the consumption of precious time and resources. This study demonstrates an optimized and proven screening technique in the discovery of two potential small molecule inhibitors of Zika virus Methyltransferase and RNA-dependent RNA polymerase. This in silico “per-residue energy decomposition pharmacophore” virtual screening approach will be critical in aiding scientists in the discovery of not only effective inhibitors of Zika viral targets, but also a wide range of anti-viral agents.

Keywords: NS5 protein inhibitors, per-residue decomposition, pharmacophore model, virtual screening, Zika virus

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Authors: Sophia Hayes, Kenny L. Liang, Sahil Sharma, Austin Shema, Mahmoud Bader, Mohamed Elbarkouky

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Despite being one of the most significant economic contributors of the country, Canada’s construction industry is lagging behind other sectors when it comes to labor productivity improvements. The construction industry is very collaborative as a general contractor, will hire trade contractors to perform most of a project’s work; meaning low productivity from one contractor can have a domino effect on the shared success of a project. To address this issue and encourage trade contractors to improve their productivity tracking methods, an investigative study was done on the productivity views and tracking methods of various trade contractors. Additionally, an in-depth review was done on four standard tracking methods used in the construction industry: cost codes, benchmarking, the job productivity measurement (JPM) standard, and WorkFace Planning (WFP). The four tracking methods were used as a baseline in comparing the trade contractors’ responses, determining gaps within their current tracking methods, and for making improvement recommendations. 15 interviews were conducted with different trades to analyze how contractors value productivity. The results of these analyses indicated that there seem to be gaps within the construction industry when it comes to an understanding of the purpose and value in productivity tracking. The trade contractors also shared their current productivity tracking systems; which were then compared to the four standard tracking methods used in the construction industry. Gaps were identified in their various tracking methods and using a framework; recommendations were made based on the type of trade on how to improve how they track productivity.

Keywords: labor productivity, productivity tracking methods, trade contractors, construction

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Authors: Osama H. Elsayed, Mohsen M. S. Asker, Mahmoud A. Swelim, Ibrahim H. Abbas, Aziza I. Attwa, Mohamed E. El Awady

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Hydroxy marilone C is a bioactive metabolite was produced from the culture broth of Streptomyces badius isolated from Egyptian soil. hydroxy marilone C was purified and fractionated by silica gel column with a gradient mobile phase dicloromethane (DCM) : Methanol then Sephadex LH-20 column using methanol as a mobile phase. It was subjected to many instruments as Infrared (IR), nuclear magnetic resonance (NMR), Mass spectroscopy (MS) and UV spectroscopy to the elucidation of its structure. It was evaluated for antioxidant, cytotoxicity against human alveolar basal epithelial cell line (A-549) and human breast adenocarcinoma cell line (MCF-7) and antiviral activities; showed that the maximum antioxidant activity was 78.8 % at 3000 µg/ml after 90 min. and the IC50 value against DPPH radical found about 1500 µg/ml after 60 min. By Using MTT assay the effect of the pure compound on the proliferation of A-549 cells and MCF-7 cells were 443 µg/ml and 147.9 µg/ml, respectively. While for detection of antiviral activity using Madin-Darby canine kidney (MDCK) cells the maximum cytotoxicity was at 27.9% and IC50 was 128.1µg/ml. The maximum concentration required for protecting 50% of the virus-infected cells against H1N1 viral cytopathogenicity (EC50) was 33.25% for 80 µg/ml. This results indicated that the hydroxy marilone C has a potential antitumor and antiviral activities.

Keywords: hydroxy marilone C, production, bioactive compound, Streptomyces badius

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Authors: Susan Scott, Dina Hanna, Bassel Zebian, Gary Ruiz, Sreena Das

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Although the number of cases of TB in England has fallen over the last 4 years, it remains an important public health burden with 1 in 20 cases dying annually. The vast majority of cases present in non-UK born individuals with social risk factors. We present a case of non-pulmonary TB presenting in a healthy child born in the UK to professional parents. We present a case of a healthy 10 year old boy who developed acute back pain during school PE. Over the next 5 months, he was seen by various health and allied professionals with worsening back pain and kyphosis. He became increasing unsteady and for the 10 days prior to admission to our hospital, he developed fevers. He was admitted to his local hospital for tonsillitis where he suffered two falls on account of his leg weakness. A spinal X-ray revealed a pathological fracture and gibbus formation. He was transferred to our unit for further management. On arrival, the patient had lower motor neurone signs of his left leg. He underwent spinal fixture, laminectomy and decompression. Microbiology samples taken intra-operatively confirmed Mycobacterium Tuberculosis. He had a positive Mantoux and T-spot and treatment were commenced. There was no evidence of immune compromise. The patient was born in the UK, had a BCG scar and his only travel history had been two years prior to presentation when he travelled to the Phillipines for a short holiday. The patient continues to have issues around neuropathic pain, mobility, pill burden and mild liver side effects from treatment. Discussion: There is a paucity of case reports on spinal TB in paediatrics and diagnosis is often difficult due to the non-specific symptomatology. Although prognosis on treatment is good, a delayed diagnosis can have devastating consequences. This case highlights the continued need for higher index of suspicion and diagnosis in a world with changing patterns of migration and increase global travel. Surgical intervention is limited to the most serious cases to minimise further neurological damage and improve prognosis. There remains the need for a multi-disciplinary approach to deal with challenges of treatment and rehabilitation.

Keywords: tuberculosis, non-pulmonary TB, public health burden, diagnostic challenge

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Authors: Mohamed Bakry Mohamed Ali, Mohamed Ehab El-Din Mustafa, Joseph Naiem Sabet Aziz, Sarah Mahmoud Ali Kaooh

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Background: Acute lung injury (ALI) is one of the major challenges in intensive care medicine. The most common extrapulmonary cause of ALI is sepsis, accounting more than 30% of the cases in humans. Lipopolysaccharide (LPS) has gained wide acceptance as a clinically relevant model of ALI. Lipopolysaccharide is a glycoprotein forming the major constituent of bacterial endotoxin. Losartan is angiotensin II type 1 (AT1) receptor antagonists. It is widely used for management of hypertension. It was recently suggested that losartan protects against septic ALI. It would thereby prevent LPS-induced ALI. Aim of the work and design of the experiment: This work investigated the injurious effect of lipopolysaccharide (LPS) and ALI on adult male albino rat at 24 hours and 14 days of LPS administration and the possible protective role of losartan pretreatment. LPS has deteriorated animal survival and behavior. It increased lung weight and induced lung histological damage. These changes could be much reduced by the losartan pretreatment. Conclusion: Administration of losartan before LPS could largely reduce these LPS/ ALI induced short and long term alterations. It could be recommended that patients susceptible to developing ALI, as in ICU, should receive a protective dose of angitensin II type 1 (AT1) receptor blocker as losartan.

Keywords: acute lung injury (ALI), lipopolysaccharide (LPS), losartan

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Authors: Amine Harrane, Mahmoud Belalia

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During the last decade, polymer layered silicate nanocomposites have received increasing attention from scientists and industrial researchers because they generally exhibit greatly improved mechanical, thermal, barrier and flame-retardant properties at low clay content in comparison with unfilled polymers or more conventional micro composites. Poly(ε-caprolactone) (PCL)-layered silicate nanocomposites have the advantage of adding biocompatibility and biodegradability to the traditional properties of nanocomposites. They can be prepared by in situ ring-opening polymerization of ε-caprolactone using a conventional initiator to induce polymerization in the presence of an organophilic clay, such as organomodified montmorillonite. Messersmith and Giannelis used montmorillonite exchanged with protonated 12-amino dodecanoic acid and Cr3+ exchanged fluorohectorite, a synthetic mica type of silicate. Sn-based catalysts such as tin (II) octoate and dibutyltin (IV) dimethoxide have been reported to efficiently promote the polymerization of ε-caprolactone in the presence of organomodified clays. In this work, we have used an alternative method to prepare PCL/montmorillonite nanocomposites. The cationic polymerization of ε-caprolactone was initiated directly by Maghnite-TOA, organomodified montmorillonite clay, to produce nanocomposites (Scheme 1). Resulted from nanocomposites were characterized by X-ray diffraction (XRD), transmission electron microscopy (TEM), force atomic microscopy (AFM) and thermogravimetry.

Keywords: polycaprolactone, polycaprolactone/clay nanocomposites, biodegradables nanocomposites, Maghnite, Insitu polymeriation

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Authors: Dina Siniora, Jasia Baig

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During the past few decades, the healthcare system has undergone profound changes in their healthcare decision-making competencies and moral aptitudes due to the vast advancement in technology, clinical skills, and scientific knowledge. Healthcare decision-making deals with morally contentious dilemmas ranging from illness, life and death judgments that require sensitivity and awareness towards the patient’s preferences while taking into consideration medicine’s abilities and boundaries. As the ever-evolving field of medicine continues to become more scientifically and morally multifarious; physicians and the hospital administrators increasingly rely on ethics committees to resolve problems that arise in everyday patient care. The role and latitude of responsibilities of ethics committees which includes being dispute intermediaries, moral analysts, policy educators, counselors, advocates, and reviewers; suggest the importance and effectiveness of a fully integrated committee. Despite achievements on Integrated Ethics and progress in standards and competencies, there is an imminent necessity for further improvement in quality within ethics consultation services in areas of credentialing, professionalism and standards of quality, as well as the quality of healthcare throughout the system. These concerns can be resolved first by collecting data about particular quality gaps and comprehend the level to which ethics committees are consistent with newly published ASBH quality standards. Policymakers should pursue improvement strategies that target both academic bioethics community and major stakeholders at hospitals, who directly influence ethics committees. This broader approach oriented towards education and intervention outcome in conjunction with preventive ethics to address disparities in quality on a systematic level. Adopting tools for improving competencies and processes within ethics consultation by implementing a credentialing process, upholding normative significance for the ASBH core competencies, advocating for professional Code of Ethics, and further clarifying the internal structures will improve productivity, patient satisfaction, and institutional integrity. This cannot be systemically achieved without a written certification exam for HCEC practitioners, credentialing and privileging HCEC practitioners at the hospital level, and accrediting HCEC services at the institutional level.

Keywords: ethics consultation, hospital, medical ethics, quality

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Authors: S. H. Atef, N. H. Mahmoud, S. Abdrahman, A. Fattoh

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Background: The aim of the study is to assess the diagnostic value of fibrotest and hyaluronic acid in discriminate between insignificant and significant fibrosis. Also, to find out if these parameters could replace liver biopsy which is currently used for selection of chronic hepatitis C patients eligible for antiviral therapy. Study design: This study was conducted on 52 patients with HCV RNA detected by polymerase chain reaction (PCR) who had undergone liver biopsy and attending the internal medicine clinic at Ain Shams University Hospital. Liver fibrosis was evaluated according to the METAVIR scoring system on a scale of F0 to F4. Biochemical markers assessed were: alpha-2 macroglobulin (α2-MG), apolipoprotein A1 (Apo-A1), haptoglobin, gamma-glutamyl transferase (GGT), total bilirubin (TB) and hyaluronic acid (HA). The fibrotest score was computed after adjusting for age and gender. Predictive values and ROC curves were used to assess the accuracy of fibrotest and HA results. Results: For fibrotest, the observed area under curve for the discrimination between minimal or no fibrosis (F0-F1) and significant fibrosis (F2-F4) was 0.6736 for cutoff value 0.19 with sensitivity of 84.2% and specificity of 85.7%. For HA, the sensitivity was 89.5% and specificity was 85.7% and area under curve was 0.540 at the best cutoff value 71 mg/dL. Multi-use of both parameters, HA at 71 mg/dL with fibrotest score at 0.22 give a sensitivity 89.5%, specificity 100 and efficacy 92.3% (AUC 0.895). Conclusion: The use of both fibrotest score and HA could be as alternative to biopsy in most patients with chronic hepaitis C putting in consideration some limitations of the proposed markers in evaluating liver fibrosis.

Keywords: fibrotest, liver fibrosis, HCV RNA, biochemical markers

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Authors: Ghada El-Husseiny, Dina Yousri, Christian Richter

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Social services are often characterized by market failures, which justifies government intervention in the provision of these services. It is widely acknowledged that government intervention breeds corruption since resources are being transferred from one party to another. However, what is still being extensively studied is the magnitude of the negative impact of corruption on publicly provided services and development outcomes. Corruption has the power to hinder development and cripple our march towards the Sustainable Development Goals. Corruption diminishes the efficiency and effectiveness of public health and education spending and directly impacts the outcomes of these sectors. This paper empirically examines the impact of Institutional Failure on public sector services provision, with the sole purpose of studying the impact of corruption on SDG3 and 4; Good health and wellbeing and Quality education, respectively. The paper explores the effect of corruption on these goals from various perspectives and extends the analysis by examining if the impact of corruption on these goals differed when it accounted for the current corruption state. Using Pooled OLS(Ordinary Least Square) and Fixed effects panel estimation on 22 corrupt and 22 clean countries between 2000 and 2017. Results show that corruption in both corrupt and clean countries has a more severe impact on Health than the Education sector. In almost all specifications, corruption has an insignificant effect on School Enrollment rates but a significant effect on Infant Mortality rates. Results further indicate that, on average, a 1 point increase in the CPI(Consumer Price Index) can increase health expenditures by 0.116% in corrupt and clean countries. However, the fixed effects model indicates that the way Health and Education expenditures are determined in clean and corrupt countries are completely country-specific, in which corruption plays a minimal role. Moreover, the findings show that School Enrollment rates and Infant Mortality rates depend, to a large extent, on public spending. The most astounding results-driven is that corrupt countries, on average, have more effective and efficient healthcare expenditures. While some insights are provided as to why these results prevail, they should be further researched. All in all, corruption impedes development outcomes, and any Anti-corrupt policies taken will bring forth immense improvements and speed up the march towards sustainability.

Keywords: corruption, education, health, public spending, sustainable development

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Authors: Ahmed Mostafa, Mohamed Mahmoud, Nesreen H. Hafez, Mohamed Fahim

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This retrospective study includes 60 patients with pre-invasive breast cancer. Aim of the study: Evaluation of premalignant lesions of the breast (DCIS), different treatment methods and outcome. Patients and methods: 60 patients with DCIS were studied from the period between 2005 to 2012, for 38 patients the primary surgical method was wide local resection (WLE) (63.3%) and the other cases (22 patients, 36.7%) had mastectomy, fourteen cases from those who underwent local excision received radiotherapy, while no adjuvant radiotherapy was given for those who underwent mastectomy. In case of hormonal receptor positive DCIS lesions hormonal treatment (Tamoxifen) was given after local control. Results: No difference in overall survival between mastectomy & breast conserving therapy (wide local excision and adjuvant radiotherapy), however local recurrence rate is higher in case of breast conserving therapy, also no role of Axillary evacuation in case of DCIS. The use of hormonal therapy decreases the incidence of local recurrence by about 98%. Conclusion: The main management of DCIS is local treatment (wide local excision and radiotherapy) with hormonal treatment in case of hormone receptor positive lesions.

Keywords: ductal carcinoma in situ, surgical treatment, radiotherapy, breast conserving therapy, hormonal treatment

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Authors: Ghzlan Mahmoud Abdel Aziz

Abstract:

This case study aims to identify the intrastate conflicts between the nation state and armed groups. Nowadays, most wars weaken states against armed groups. Thus, it is very important to negotiate with such groups in order to reinforce the law for the protection of victims. These armed groups are the cause of conflicts and they are related with many of humanitarian issues that result out of conflicts. In this age of rivalry; terrorists, insurgents, or transnational criminal parties have surfaced to the top as a reaction to these armed groups in an effort to set up a new world order. Moreover, the intra state conflicts became increasingly treacherous than the interstate conflicts, particularly when nation state systems deal with armed groups which try to influence the state. The unexpected upraising of the Arab Spring during 2011 in parts of the Middle East and North Africa formed various patterns of conflicts. The events of the Arab Spring resulted in current and long term change across the region. Significant modifications in the level, strength and period of armed conflict around the world have been made. Egypt was in the center of these events. It has fought back the armed groups under the name of terrorism and spread common disorder and violence among civilians. On this note, this study focuses on the problem of the transformation in the methods of organized violence within one state rather than between two state or more and analyzes the objectives, strategies, and internal composition of armed groups and the environments that foster them, with a focus on the Egyptian case.

Keywords: armed groups, conflicts, Egyptian armed forces, intrastate conflicts

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Authors: Mariam Aref Mahmoud

Abstract:

A myth surrounding the development of Cairo bases itself in the Fatimid era when the city, as we know it today, was built. Surrounding the city was a wall meant to protect the main center from any possible attack. The effects of global hierarchies of power extend further than labor regulations and trade statistics. Beyond that, they form dialectical oppositions between local and global identities within urban space. As such, those in power often aim to claim national identity as what they perceive to be the most nationally beneficial strategy. These claims over perceptions of national identity take over the streets, the advertisements, and the parks and eventually make their way into the different forms of media. Often, these claims take over the main planning goals of the city. Whether it is through the control over which sounds are allowed to be produced in public space, what type of people are encouraged to enter which spaces, or other forms of performing local and national identity, public space, property, and land have often been used as a method to present to both the public and the global population what people in power wish for these spaces to represent. In Egypt, these developments have been changing since the end of colonial rule. In particular, this paper will analyze how Hosni Mubarak, and to a certain extent Anwar el-Sadat, enacted neoliberal designs dedicated towards modernization in order to present an image of a Cairo that is not uniquely Egyptian but essentially Western cosmopolitan - a Cairo that belongs to a globalized world.

Keywords: Egypt, imperialism, westernization, housing

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Authors: Mahmoud Tarek, Alaa Obeida, Mai Magdy, Khalid Hussein, Aly Shalaby

Abstract:

Background: More doctors are complaining of burnout than before, Burnout is a state of physical and mental exhaustion caused by the doctor’s lifestyle, unfortunately, Medical errors are also more likely in those suffering from burnout and these may result in malpractice suits. Methodology: It is a retrospective audit of burnout response on all neonatologists over a 9 months period. We gathered data using burnout questionnaire, it was obtained from 23 physicians, the physicians divided into 5 categories according to the final score of the 28 questions in the questionnaire. Category 1 with score from 28-38 with almost no work stress, category 2 with score (38-50) who express a low amount of job related stress, category 3 with score (51-70) with moderate amount of stress, category 4 with score (71-90) those express a high amount of job stress and begun to burnout, category 5 with score (91 and above) who are under a dangerous amount of stress and advanced stage of burnout. Results: 33 neonatologists have received the questionnaire, 23 responses were sent back with a response rate of 69.6%. The results showed that 61% of physicians fall in category 4, 31% of the physician in category 5, while 8% of physicians equally distributed between category 2 and 3 (4% each of them). On the other hand, there is no physician present in category 1. Conclusion: Burnout is prevalent in SNICUs, So interventions to minimize burnout prevalence may be of greater importance as this may be reflected indirectly on medical conditions of the patients and physicians, efforts should be done to decrease this high rate of burnout.

Keywords: Cairo, work overload, exhaustion, surgery, neonatal ICU

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Authors: Mohamed Rasslan, Doaa Abdelrahman, Mahmoud M. Nasreldin, Ghada Farouk, Heba K. Aslan

Abstract:

Blockchain is a distributed database that endorses transparency while bitcoin is a decentralized cryptocurrency (electronic cash) that endorses anonymity and is powered by blockchain technology. Smart contracts are programs that are stored on a blockchain. Smart contracts are executed when predetermined conditions are fulfilled. Smart contracts automate the agreement execution in order to make sure that all participants immediate-synchronism of the outcome-certainty, without any intermediary's involvement or time loss. Currently, the Bitcoin market worth billions of dollars. Bitcoin could be transferred from one purchaser to another without the need for an intermediary bank. Network nodes through cryptography verify bitcoin transactions, which are registered in a public-book called “blockchain”. Bitcoin could be replaced by other coins, merchandise, and services. Rapid growing of the bitcoin market-value, encourages its counterparts to make use of its weaknesses and exploit vulnerabilities for profit. Moreover, it motivates scientists to define known vulnerabilities, offer countermeasures, and predict future threats. In his paper, we study blockchain technology and bitcoin from the attacker’s point of view. Furthermore, mitigations for the attacks are suggested, and contemporary security solutions are discussed. Finally, research methods that achieve strict security and privacy protocol are elaborated.

Keywords: Cryptocurrencies, Blockchain, Bitcoin, Smart Contracts, Peer-to-Peer Network, Security Issues, Privacy Techniques

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Authors: Alaa Al Hawari, Mohammad Khader, Wael El Hasan, Mahmoud Alijla, Ammar Manawi, Abdelbaki Benamour

Abstract:

The production of aluminium alloys and ingots -starting from the processing of alumina to aluminium, and the final cast product- was studied using a Life Cycle Assessment (LCA) approach. The studied aluminium supply chain consisted of a carbon plant, a reduction plant, a casting plant, and a power plant. In the LCA model, the environmental loads of the different plants for the production of 1 ton of aluminium metal were investigated. The impact of the aluminium production was assessed in eight impact categories. The results showed that for all of the impact categories the power plant had the highest impact only in the cases of Human Toxicity Potential (HTP) the reduction plant had the highest impact and in the Marine Aquatic Eco-Toxicity Potential (MAETP) the carbon plant had the highest impact. Furthermore, the impact of the carbon plant and the reduction plant combined was almost the same as the impact of the power plant in the case of the Acidification Potential (AP). The carbon plant had a positive impact on the environment when it comes to the Eutrophication Potential (EP) due to the production of clean water in the process. The natural gas based power plant used in the case study had 8.4 times less negative impact on the environment when compared to the heavy fuel based power plant and 10.7 times less negative impact when compared to the hard coal based power plant.

Keywords: life cycle assessment, aluminium production, supply chain, ecological impacts

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Authors: Maha Salah Abdullah Ismail, Mahmoud M. Alsagheir, Mohammed Salah Abd Allah

Abstract:

Acute respiratory distress syndrome (ARDS) is characterized by permeability pulmonary edema and refractory hypoxemia. Lung-protective ventilation is still the key of better outcome in ARDS. Prone position reduces the trans-pulmonary pressure gradient, recruiting collapsed regions of the lung without increasing airway pressure or hyperinflation. Prone ventilation showed improved oxygenation and improved outcomes in severe hypoxemic patients with ARDS. This study evaluates the effect of prone positioning on mechanically ventilated patients with ARDS. A quasi-experimental design was carried out at Critical Care Units, on 60 patients. Two tools were utilized to collect data; Socio demographic, medical and clinical outcomes data sheet. Results of the present study indicated that prone position improves oxygenation in patients with severe respiratory distress syndrome. The study recommended that use prone position in patients with severe ARDS, as early as possible and for long sessions. Also, replication of this study on larger probability sample at the different geographical location is highly recommended.

Keywords: acute respiratory distress syndrome, critical care, mechanical ventilation, prone position

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Authors: Mahmoud Abu-Ghoush, Murad Al Holy

Abstract:

Our main goal in this project is to study the causes and finding solutions for both the hydrolytic and the oxidative rancidity that can be produced during condensed yoghurt production. The re pasteurization of the pasteurized milk and the addition of different types of antioxidants (ascorbic acid and propyl gallate) were used to achieve this goal. Chemical, physical, microbial and sensory tests were done to evaluate the product. It was found that there were significant differences between the different treatments and the control regarding the peroxide value. This means that the addition of both types of antioxidants have a positive effect in decreasing the rancidity value. However, it was found that there were some samples have hydrolytic rancidity flavour without any type of oxidative rancidity (low peroxide value). To overcome this problem the re pasteurization step was used to destroy all the vegetative form of microbes. It was found that this treatment was very useful in controlling the rancidity flavour according to the sensory evaluation of the condensed yoghurt products for several batches. The best condensed yoghurt which contains 0.25% ascorbic acid exhibited the highest sensory properties values. Also, it has the ability in lowering the oxidative rancidity in the combination with the re pasteurization step of the pasteurized milk. This suggests that a higher quality and stable condensed yoghurt can be obtained upon using this combination. These results may help producers in selecting the best treatment methods to overcome the rancidity flavor in this type of condensed yoghurt.

Keywords: antioxidants, condensed yoghurt, repasturization, condensed milk

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Authors: Mona Mahmoud Abou Samra, Alaa Hamed Salama, Ghada Awad, Soheir Said Mansy

Abstract:

Proniosomes are well documented for topical drug delivery and preferred over other vesicular systems because they are biodegradable, biocompatible, non-toxic, possess skin penetration ability and prolong the release of drugs by acting as depot in deeper layers of skin. Proniosome drug delivery was preferred due to improved stability of the system than niosomes. The present investigation aimed at formulation development and performance evaluation of proniosomal gel as a vesicular drug carrier system for antifungal drug tolnaftate. Proniosomes was developed using different nonionic surfactants such as span 60 and span 65 with cholesterol in different molar ratios by the Coacervation phase separation method in presence or absence of either lecithin or phospholipon 80 H. Proniosomal gel formulations of tolnaftate were characterized for vesicular shape & size, entrapment efficiency, rheological properties and release study. The effect of surfactants and additives on the entrapment efficiency, particle size and percent of drug released was studied. The selected proniosomal formulations for topical delivery of tolnaftate was subjected to a microbiological study in male rats infected with Trichophyton rubrum; the main cause of Tinea Pedis compared to the free drug and a market product and the results was recorded.

Keywords: fungal infection, proniosome, tolnaftate, trichophyton rubrum

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Authors: Leila Yazdanpanah, Hajieh Shahbazian, Seyed Mahmoud Latifi, Armaghan Moravej Aleali, Saeed Ghanbari

Abstract:

Introduction: This study was designed to determine the prevalence of diabetes in people aged over 20 years in Ahvaz, Iran. Material and Methods: The study population selected by cluster sampling. Fasting blood sugar (FBS) assessed after minimum 8 hours night fasting. A questionnaire included: age, sex, weight, height, blood pressure, waist circumference and previous history of diabetes were completed for each patient. FBS≥126mg/dl and/or oral hypoglycemic treatment and/or insulin was defined as diabetes, FBS=100-125 mg/dl as impaired fasting glucose (IFG) and FBS<100mg/dl as normal. Results: Study population was 936 persons (47.2 % male and 52.8% female). The mean age of a population was 42.2±14 years. Diabetes was detected in 15.1 % of population. Only 57cases(6.1%) were aware of their disease and 9% had unknown diabetes. Diabetes was detected in 14.5% of male (11.3% unknown and 3.2 % known diabetes) and in 11.7% of female (7% unknown and 4.7% known diabetes). Prevalence of diabetes had no significant difference (P=0.21) in male and female but unknown diabetes was significantly higher in male (P=0.025). Prevalence of diabetes was increased with rising of age between 20-60 years old but decreasing after 60 years old. Diabetes was related to age, waist circumference and systolic and diastolic blood pressure, TG level and BMI in both sex (P=0.0001). Conclusion: More than half of female and three-fourth of male diabetic patients are unaware of their disease in South of Iran. Diabetes screening should be intensified in this population.

Keywords: diabetes, prevalence, risk factor, awareness

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Authors: Mahmoud Hassanin, Amita Gupta

Abstract:

Background: During current practice, Thiopentone is not cost-effectively added to resources wastage, risk of drug error with antibiotics, short shelf life, infection risk, and risk of delay while preparing during category one cesarean section. There is no significant difference or preference to the other alternative as per current use. Aims and Objectives: Patient safety, Cost-effective use of trust resources, problem awareness, Consider improvising on the current practice. Methods: In conjunction with the local department survey results, many studies support the change. Results: More than 50%(15 from 29) are already using Propofol, more than 75% of the participant are willing to shift to Propofol if it becomes standard, and the cost analysis also revealed that Thiopentone 10 X500=£60 Propofol 10X200= £5.20, Cost of Thiopentone/year =£2190. Approximately GA in a year =35-40 could cost approximately £20 Propofol, given it is a well-established practice. We could save not only money, but it will be environmentally friendly also to avoid adding any carbon footprints. Recommendation: Thiopentone is rarely used as an induction agent for the category one Caesarean section in our obstetric emergency theatres. Most obstetric anesthetists are using Propofol. Keep both Propofol and thiopentone(powder not withdrawn) in the cat one cesarean section emergency drugs tray ready until the department completely changes the practice protocol. A further retrospective study is required to compare the outcomes for these induction agents through the local database.

Keywords: thiopentone, propofol, category 1 caesarean, induction agents

Procedia PDF Downloads 142