Marzouk, M., S. Azab, N. Elshaboury, A. Megahed, M. Metawie, M. E. Hawary, doaa ghaith, and {A. E. M. } Bayoumi, Modeling {COVID}-19 effects on {SDGs} using system dynamics in Egypt, , vol. 29, no. 39, pp. 59235–59246, 2022. AbstractWebsite

The coronavirus disease 2019 ({COVID}-19) poses a significant threat to achieving the Sustainable Development Goals ({SDGs}). To address this challenge, a thorough examination of the pandemic’s influence on four {SDGs} in Egypt is presented in a system dynamic model. The addressed goals are related to no poverty ({SDG} 1), zero hunger ({SDG} 2), decent work and economic growth ({SDG} 8), and climate action ({SDG} 13). The model is simulated over 35 years extending from 2015 to 2050. Furthermore, a web-based interactive learning environment is developed to analyze the interdependencies among public health activities and study the impacts of possible intervention countermeasures or prevention policies. Indicators including poverty line, food insecurity, gross domestic product ({GDP}) growth rate, and greenhouse gas ({GHG}) emissions are evaluated to track Egypt’s performance in relation to {SDGs} 1, 2, 8, and 13. According to the simulation model, the poverty line will continue to decline until it reaches around 16% by 2050. According to the significant governmental efforts to follow its vision of 2030, Egypt can achieve a decreasing percentage of food insecurity, reaching 3% in 2030, and this percentage will continue to decrease until it reaches full sufficiency by 2050. The {GDP} growth rate will rise every year until it reaches 13.71% in 2050. With respect to climate, {GHG} emissions are predicted to fall to roughly 97 Mt {CO}2-equivalents by 2050. This approach revitalizes debates about the achievement of {SDGs} amid the crisis and acts as a powerful tool that aids decision-makers in identifying leverage points to avoid the long-term negative repercussions of the crisis on the economy, people, and environment.

Soliman, L. A., R. A. Zayed, D. Omran, F. Said, S. K. Darweesh, D. M. Ghaith, R. E. Etreby, M. S. Barakat, M. M. Bendary, D. Z. Zaky, et al., Apelin Association with Hepatic Fibrosis and Esophageal Varices in Patients with Chronic Hepatitis C Virus, , vol. 107, no. 1, pp. 190–197, 2022. AbstractWebsite

Portal hypertension and esophageal varices complicating hepatitis C virus ({HCV})-related chronic liver diseases are some of the most devastating sequelae. Angiogenesis is the hallmark of their pathogenesis. Apelin is one of the recently identified angiogenic and fibrogenic peptides. We studied apelin gene expression, apelin (rs3761581) single-nucleotide polymorphism ({SNP}), and serum apelin level in patients with chronic {HCV}, and their association with liver fibrosis and esophageal varices in 112 patients with {HCV}-related chronic liver disease (40 with liver cirrhosis [{LC}]/low-grade varices, 33 with {LC}/high-grade varices, and 39 with fibrotic non-cirrhotic liver/no varices) and 80 healthy control subjects. Real-time polymerase chain reaction was used for apelin gene expression assay and apelin rs3761581 {SNP} analysis in peripheral blood samples. The serum apelin level was measured by {ELISA}. Apelin gene expression was undetectable in the studied samples. The {SNP} analysis revealed a greater frequency of the C (mutant) allele among patients compared with control subjects (P = 0.012; odds ratio, 3.67). The serum apelin level was significantly greater in patients with {LC}/varices (median, 31.6 ng/L) compared with patients without {LC}/varices (median, 2.9 ng/L; P {\textless} 0.001). A serum apelin level cutoff value of 16.55 ng/L predicted the presence of varices, with an area under the receiver operating characteristic curve value of 0.786. A positive correlation was found between serum apelin level and grade of liver fibrosis (r = 0.346, P {\textless} 0.001) and portal hypertension (r = 0.438, P {\textless} 0.001). In conclusion, the apelin rs3761581-C allele may be associated with the progression of {HCV}-related chronic liver disease and varices formation, and can be considered a potential therapeutic target to control fibrosis progression. The serum apelin level provided an accurate prediction of the presence of esophageal varices.

Abd El-Hamid, M. I., A. H. Sewid, M. Samir, W. A. H. Hegazy, M. M. Bahnass, R. A. Mosbah, D. M. Ghaith, E. Khalifa, H. Ramadan, W. A. Alshareef, et al., Clonal Diversity and Epidemiological Characteristics of {ST}239-{MRSA} Strains, , vol. 12, 2022. AbstractWebsite

{\textless}p{\textgreater}Methicillin-resistant {\textless}italic{\textgreater}Staphylococcus aureus{\textless}/italic{\textgreater} ({MRSA}) is a major pathogen associated with severe morbidity and mortality and poses a significant threat to public health worldwide. The genetic diversity based on sequence types of {MRSA} strains was illustrated in previous studies; meanwhile, the diversity along with the predominant sequence type, especially in Egypt, remains unknown. The purpose of the current study was to determine the diversity of the predominant {MRSA} clone {ST}239-{MRSA} (n = 50) isolated from different hosts and clinical samples and to illustrate the correlation between the resistance patterns, toxin genes, and the genetic background in Port-said and El-Sharkia Governorates, Egypt. The {ST}239-{MRSA} clone was analyzed by phenotypic antibiotyping and various genotypic assays comprising {SCC}{\textless}italic{\textgreater}mec{\textless}/italic{\textgreater}, {\textless}italic{\textgreater}agr{\textless}/italic{\textgreater}, {\textless}italic{\textgreater}spa{\textless}/italic{\textgreater}, {\textless}italic{\textgreater}coa{\textless}/italic{\textgreater}, and {\textless}italic{\textgreater}coa{\textless}/italic{\textgreater}-{RFLP} in addition to toxin gene profiles. Most of the analyzed strains (40/50, 80%) were multidrug resistant ({MDR}), belonged to {SCC}{\textless}italic{\textgreater}mec{\textless}/italic{\textgreater}-{III}, {\textless}italic{\textgreater}agr{\textless}/italic{\textgreater}-I, and {\textless}italic{\textgreater}coa{\textless}/italic{\textgreater} genotype I, and harbored {\textless}italic{\textgreater}sea{\textless}/italic{\textgreater} and {\textless}italic{\textgreater}pvl{\textless}/italic{\textgreater} genes. A negative correlation between the toxin gene profiles and antimicrobial resistance was recorded. Meanwhile, the correlation between the toxin gene profiles and the genetic background was not observed in this study. Although {ST}239-{MRSA} strains belonged to a single sequence type, they exhibited a high degree of phenotypic and genotypic diversity, indicating weak clonality and adaptability. With such diversity, it is assumed that these strains may have undergone different evolutionary processes during transmission events among and/or within a single host or tissue niche.{\textless}/p{\textgreater}

Mohamed, A. A., M. S. Hussein, E. M. Salah, A. Eldemery, M. M. Darwish, D. M. Ghaith, R. A. Attala, and R. E. Borolossy, Efficacy and safety of active vitamin D supplementation in chronic spontaneous urticaria patients, , vol. 33, no. 1, pp. 427–432, 2022. AbstractWebsite

Chronic spontaneous urticaria ({CSU}) is a common skin disorder affecting negatively patients’ lives. Vitamin D deficiency has been reported to be associated to many allergic skin disorders. This study aimed to evaluate the association between the serum level of 25 hydroxy vitamin D and {CSU} and to assess the efficacy and safety of active vitamin D in management of {CSU}. The study was conducted on 77 patients with {CSU} and 67 healthy controls, then the 77 {CSU} patients were randomized to either the study group that received 0.25 µg alfacalcidol daily or the placebo group that received oral placebo for 12 weeks. Serum 25({OH}) D was significantly lower in {CSU} as compared to healthy controls and was negatively correlated to the urticarial severity. After alfacalcidol administration, the study group showed significant higher level of 25({OH}) D compared to the placebo group. In addition, the mean serum level of {IL}6, {hsCRP} and {TNFα} significantly decreased in the study group in comparison to the placebo group and as compared to their baseline results. Vitamin D deficiency is more common in {CSU} patients as compared to healthy people and hence, alfacalcidol might have a beneficial role as add on therapy in {CSU} management with no reported side effects.

Wassef, M., R. H. A. Yousef, M. M. Hussein, M. O. S. T. A. F. A. A. EL-SHAZLY, and D. M. Ghaith, "Surgical Site Infections in Post-Living Donor Liver Transplantation: Surveillance and Evaluation of Care Bundle Approach", Open Access Macedonian Journal of Medical Sciences, vol. 10, pp. 1411–1416, 2022. AbstractWebsite

Background and Aim: Although implantation of a care bundle approach is well established in intensive care units ({ICUs}), yet its impact on reducing surgical site infections ({SSI}) among post living-donor-liver transplantation ({LDLT}) patients has not been established. Our aim is to evaluate the impact of a care bundle in reducing {SSI} and to detect the pattern of antibiotic resistance in {LDLT}. Materials and Methods: This before and after comparative study was conducted at Elmanial specialized tertiary hospital, Cairo University over a period of 3 years (January 2016 - December 2018) including 57 {LDLT} patients. We introduced a care bundle comprised of a group of evidence-based practices implemented together. The study was divided into three phases. All bacterial identification and antibiotic sensitivity testing were done by a Vitek 2 compact system. Results: {SSIs} rates were reduced significantly by 30.4% from the pre-implementation to the post implementation phase (from 13/24, 54.2% to 5/21, 23.8%, {OR} 0.21, {CI} 95%: 1.137- 0.039). This reduction went hand in hand with increase in the hand hygiene compliance from 57.3 % to 78 %, then remained sustained with a median rate of 78% in the last 6 months. Klebsiella pneumoniae 11{\textbackslash}25 (44% of {SSIs}), Acinetobacter baumannii 8{\textbackslash}25 (32% of {SSIs}), Escherichia coli 5{\textbackslash}25 (20%), Pseudomonas aeruginosa 5{\textbackslash}25 (20%) and {MRSA} 4{\textbackslash}25 (16%). With predominance of {XDR} phenotype 14/25 (56%), followed by {ESBL} of gram-negative bacteria 6/25 (24%), then {MRSA} 4/25 (16%). Conclusion: {SSIs} in {LDLT} mandates strict implementation of comprehensive evidence-based care bundles for better patent outcome.

Abdelhalim, M. M., G. S. Saafan, H. S. El-Sayed, and D. M. Ghaith, "In vitro antibacterial effect of probiotics against Carbapenamase-producing multidrug-resistant Klebsiella pneumoniae clinical isolates, Cairo, Egypt", Journal of the Egyptian Public Health Association, vol. 97, no. 1, pp. 19, 2022. AbstractWebsite

Searching for a non-antibiotic therapeutic option such as probiotics is gaining momentum nowadays. We aimed to evaluate the in vitro antibacterial ability of cell-free supernatant ({CFS}) of selected Lactobacillus strains (with probiotic properties) against clinical isolates of {OXA}-48-producing multidrug-resistant ({MDR}) Klebsiella pneumoniae separately and in combination with cefoperazone antibiotic.

Mohamed, A. A., S. Abd-Elsalam, A. Abdelghani, M. B. Hassan, doaa ghaith, O. Ezzat, D. A. El-damasy, N. N. Madbouli, M. Hamada, M. A. K. Elkady, et al., "Human {ACE}-2, {MCP}1 and micro-{RNA} 146 as Novel Markers for {COVID}- 19 Affection and Severity", Infectious Disorders - Drug {TargetsDisorders}), vol. 23, no. 1, pp. 52–61, 2023. Abstract

Background & Aims: Coronavirus disease - 2019 ({COVID}-19) is a major pandemic that causes high morbidity and mortality rates. Aim of this study: to detect the relations between many risk factors, {ACE}-2, {MCP}-1, Micro {RNA} 146 gene expression, and {COVID}-19 infection and disease severity. Methods: This study was carried out on 165 cases of {COVID}-19 and 138 controls. {ACE}2 and {MCP}1 levels were measured in {COVID}-19 cases and control by {ELISA} and micro-{RNA}-146 expression by {PCR}. Results: We found an increased blood level of {ACE}2 and {MCP}1 in {COVID}- 19 patients than in healthy persons and a significant down-regulation of micro-{RNA} 146 gene expression in cases than in controls. There was a significant correlation between increased blood level of {ACE}2, regulation of micro-{RNA} 146 gene expression and severity of lung affection, a significant correlation was found between increased blood level of {MCP}1 and thrombosis in {COVID}-19 patients. Neurological complications were significantly correlated with more viral load, more {ACE}2 blood level, and down regulation of micro {RNA}146 expression. Conclusion: High viral load, increased blood level of {ACE}2, and down-regulation of micro-{RNA} 146 expression are associated with more severe lung injury and the presence of neurologic complications like convulsions and coma in {COVID}-19 Egyptian patients.

Mohammed, A. A., D. A. M. El-Matty, R. Abdel-Azeem, K. Raafat, M. A. Hussein, A. R. El-Ansary, W. Hafez, H. A. Hassan, N. A. Nassar, N. M. Selim, et al., "Allelic Discrimination of Vitamin D Receptor Polymorphisms and Risk of Type 2 Diabetes Mellitus: A Case-Controlled Study", Healthcare, vol. 11, no. 4, pp. 485, jan, 2023. AbstractWebsite

(1) Background: Type 2 diabetes mellitus (T2DM) is one of the rapidly growing healthcare problems, and several vitamin D receptor ({VDR}) polymorphisms seem to modulate the risk of T2DM. Our research was designed to investigate the allelic discrimination of {VDR} polymorphisms and T2DM occurrence risk. (2) Methods: This case-control research included 156 patients with T2DM and 145 healthy control subjects. Most of the study population were males 56.6% vs. 62.8% in the case and control groups, respectively. Genotyping for {VDR} single nucleotide polymorphisms ({SNPs}), rs228570 (Fok1), rs7975232 (Apa1), and rs1544410 (Bsm1) was compared between both groups. (3) Results: There was a negative link between vitamin D levels and insulin sensitivity. A significant difference was noted in the allelic discrimination of {VDR} polymorphism rs228570 and rs1544410 between the study groups (p {\textless} 0.001). No difference was observed in the allelic discrimination of {VDR} polymorphism rs7975232 between the groups (p = 0.063). Moreover, T2DM patients had significantly higher levels of fasting blood sugar ({FBS}), glycated hemoglobin {HbA}1c, 2-h post-prandial blood sugar ({PP}), serum glutamic oxaloacetic transaminase ({SGOT}), serum glutamic-pyruvic transaminase ({SGPT}), total cholesterol, and triglycerides (p {\textless} 0.001), while High-Density Lipoprotein ({HDL}) Cholesterol ({HDL}-C) was significantly decreased (p = 0.006). (4) Conclusions: {VDR} polymorphisms had a positive association with T2DM risk among the Egyptian population. Further large-scale research using deep sequencing of samples is strongly urged to investigate different vitamin D gene variants and interactions, as well as the influence of vitamin D on T2DM.

Mohammed, A. A., D. M. Abo El-Matty, E. A. Abd {ElSalam}, M. A. Hussein, W. Hafez, S. A. Ibrahim, E. A. H. Shaheen, E. A. Awad, M. A. Osman, M. S. Abd El-Raouf, et al., "Evaluating the Feasibility of Pro-Neurotensin and 25-Hydroxyvitamin D3 as Possible Indicators for Type 2 Diabetes Mellitus and Its Complications", Healthcare, vol. 11, no. 8, pp. 1088, 2023. AbstractWebsite

(1) Background: Type 2 diabetes mellitus (T2DM) and metabolic syndrome are associated with decreased vitamin D. In contrast, high pro-neurotensin (pro-{NT}) levels are linked with an increased risk of T2DM and cardiovascular disease. We aimed to determine the validity of pro-{NT} and 25-dihydroxy vitamin D3 levels as predictors for T2DM complications; (2) Methods: One hundred T2DM, and one hundred healthy volunteers participated in this case-control study. Their Pro-{NT} and 25-hydroxyvitamin D3 levels were evaluated using the {ELISA} technique; (3) Results: Pro-{NT} and 25 ({OH}) vitamin D3 have significant validity and accuracy in T2DM prediction, 84.5%, and 90.5%, respectively (p = 0.001). At a value of {\textless}29.5, 25-Hydroxy vitamin D3 showed 88% sensitivity and 93% specificity in predicting T2DM. At a value of {\textgreater}124 Pmol/L, Pro-{NT} showed 81% sensitivity and 88% specificity in predicting T2DM. At a value of 16.5, 25-Hydroxy vitamin D3 had 78.4% sensitivity and 68.3% specificity in predicting T2DM complications. At a value of {\textgreater}158 pmol/L, Pro-{NT} predicted T2DM complications with 67.6% sensitivity and 56.0% specificity; (4) Conclusions: 25 ({OH}) Vit D3 and Pro-{NT} could identify T2DM patients and predict T2DM complications. More extensive research is required to adequately validate this novel perspective with a large population study.

doaa ghaith, S. A. Morsy, M. Sebak, and R. A. Rabea, "Phenotypic and genotypic characterization of carbapenem-resistant Gram-negative organisms, Beni-Suef, Egypt", Beni-Suef University Journal of Basic and Applied Sciences, vol. 12, no. 1, pp. 61, 2023. AbstractWebsite

Carbapenem-resistant Gram-negative organisms ({CRGNO}) are a growing threat. We aimed in our study to determine the genotype of carbapenemases at Beni-Suef University Hospital by using newly introduced lateral flow assays in comparison with molecular techniques and test the effectiveness of ceftazidime/avibactam against them.