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Knee osteoarthritis (KOA) is an important cause of disability in the world and it denotes a public health defiance of the upcoming years. Aim  To examine the connection between ADAMTS14 gene rs4747096 polymorphism and KOA and to assess risk factors associated with KOA. Methods  A case control study was conducted on 158 patients with KOA and 120 controls with comparable age and sex randomly recruited from National Research Centre employees. All participants were subjected to full history taking, assessment of KOA severity using WOMAC scoring system, and thorough clinical examination. Blood sample was collected for detection of ADAMTS14/rs4747096 gene polymorphism. Results  The frequency of ADAMTS14 gene rs4747096 genotypes among patients with KOA was 73.5% for AA, 25.7% for AG, and 0.7% for GG compared to controls 963%, 31.3%, and 5.6% respectively and the frequency of alleles among patients was 86.4% for A and 78.7% for G compared to controls (78.7% and 21.3% respectively, P  < 0.05. The study found that the median levels of total WOMAC score and its domains were significantly higher among KOA patients than controls. The logistic regression analysis revealed that age ≥ 50 years, BMI ≥ 35, and long standing at work were predictive factors for KOA ( P  < 0.05). Regarding different genetic patterns, only the A recessive pattern of inheritance was found to be a predictive risk factor for KOA. Conclusion  For ADAMTS14 rs4747096 genotype, the AA and AG genotypes significantly increased the risk of KOA. The recessive pattern of inheritance, older age, morbid obesity, and prolonged standing at work were the predictive risk factors for KOA. Further studies with larger sample size are encouraged to investigate the mechanism by which this genotype can affect the development of KOA.

Background The nutritional status and growth of children with Autism spectrum disorders (ASD) is influenced significantly by two factors; food selectivity behaviors due to their consumption of a limited variety of food and the high incidence of gastrointestinal (GIT) disorders. Aim This study aimed to assess the nutritional adequacy and growth pattern of ASD children aged three to twelve years compared to their healthy developing peers. Methods A national comparative, facility-based cross-sectional study was conducted in eight Egyptian governorates on 285 Egyptian children diagnosed with ASD and 224 children who are their relatives as healthy developing peers. Anthropometric measurements were obtained, including weight, height, head circumference, and mid-upper arm circumference. Body Mass Index (BMI) was calculated and all numbers were plotted on WHO growth charts. Assessment of food preferences, and nutrient intake adequacy of children was done using the Food preference questionnaire, and the Dietary Reference Intakes (DRIs) of Egyptian children. Results Calorie-dense food and sugar intake were higher among ASD children than their healthy developing peers. ASD children omit some important protein sources such as dairy (COR = 5.2, 95% CI:2.7–9.9), meat, and poultry (COR = 2.7, 95% CI: 1.6–4.7), and a lower intake of fruits and vegetables than their healthy developing peers. For children with ASD in all age groups, a deficiency in the range of 50–60% was detected for vitamins (C, D, B6, thiamine, riboflavin, niacin) and minerals (iron). A deficiency in the range of 60–70% was detected for folate and calcium. A deficiency of vitamin C calcium and iron was also detected for both children with ASD and their healthy developing relatives aged 6 to 12 years. GIT disorders were common among ASD children compared to healthy developing peers (COR = 2.8 to 10.3). Children with ASD had four-fold higher odds of stunting (COR = 4.1, CI: 1.7–10.1), threefold higher odds of being overweight (COR = 3.3, CI: 1.48–7.32), and nearly eleven-fold higher odds of obesity (COR = 11.4, CI: 4.05–32.17) compared to their healthy developing peers. Conclusion ASD children are prone to overweight and protein malnutrition. Their intake of fruits and vegetables is inadequate and hence their intake of vitamins and minerals is insufficient, contributing to stunting.

Background Child disability has significant implications on their well-being and healthcare systems. Aim: This survey aimed to assess the magnitude of seven types of disability among Egyptian children aged 1 < 6 years and their socio-demographic, epidemiological, and perinatal predictors. Methods A national population-based cross-sectional household survey targeting 21,316 children from eight governorates was conducted. The screening questionnaire was derived from the WHO ten-question survey tool validated for identifying seven disability categories. Results The percentage of children with at least one disability was 8.1% as follows: speech/communication (4.4%), Mobility/physical (2.5%), Seizures (2.2%), Comprehension (1.7%), Intellectual impairment (1.4%), Visual (0.3%) and Hearing (0.2%). Age was not found to affect the odds of disability except for visual disability (significantly increased with age (AOR = 1.4, 95% CI:1.1–1.7). Male sex also increased the odds of all disabilities except visual, hearing, and seizures. Convulsions after birth significantly increased the odds of disability as follows: hearing (AOR = 8.1, 95% CI: 2.2–30.5), intellectual impairment (AOR = 4.2, 95% CI: 2.5–6.9), and mobility/physical (AOR = 3.4, 95% CI: 2.3–5.0). Preterm delivery and being kept in an incubator for more than two days after birth increased the odds for visual disability (AOR = 3.7, 95% CI: 1.1–12.1 & AOR = 3.7, 95% CI: 1.7–7.9 respectively). Cyanosis increased the odds of seizures (AOR = 4.7, 95% CI: 2.2–10.3). Low birth weight also increased the odds for all disability domains except for visual and hearing. Maternal health problems during pregnancy increased the odds for all types of disability except hearing and seizures. Higher paternal education decreased the odds for all disabilities by at least 30% except for vision and hearing. Conclusion The study found a high prevalence of disability among Egyptian children aged 1–6 years. It identified a number of modifiable risk factors for disability. The practice of early screening for disability is encouraged to provide early interventions when needed.

Background Early childhood life is critical for optimal development and is the foundation of future well-being. Genetic, sociocultural, and environmental factors are important determinants of child development. Aim The objectives were to screen for suspected developmental delays (DDs) among Egyptian preschool children, and to explore the determinants of these delays based on sociodemographic, epidemiological, maternal, and child perinatal risk factors. Methods A national Egyptian cross-sectional developmental screening of a representative sample of preschool children (21,316 children) aged 12 to 71 months. The Revised Denver Prescreening Developmental Questionnaire (R-PDQ) followed by the Denver Developmental Screening Test, 2 nd edition (DDST) was used. Results Each screened child manifested at least one of six developmental categories. Either typical development, gross motor delay (GM), fine motor adaptive delay (FMA), Language delay (L), Personal-social delay (PS), or multiple DDs. The prevalence of preschool children with at least one DD was 6.4%, while 4.5% had multiple DDs. Developmental language delay was the most prevalent, affecting 4.2% of children. The least affected domain was GM (1.9% of children). Boys were more likely to have DD than girls. Children in urban communities were more likely to have at least one DD than those in rural areas (OR = 1.28, 95%CI: 1.14–1.42), and children of middle social class than of low or high social class (OR = 1.49, 95%CI: 1.30–1.70 & OR = 1.40, 95%CI: 1.23–1.59 respectively). The strong perinatal predictors for at least one DD were children with a history of postnatal convulsions (OR = 2.68, 95%CI: 1.97–3.64), low birth weight (OR = 2.06, 95%CI: 1.69–2.52), or history of postnatal cyanosis (OR = 1.77, 95%CI: 1.26–2.49) and mothers had any health problem during pregnancy (OR = 1.73, 95%CI: 1.44–2.07). Higher paternal and maternal education decreased the odds of having any DD by 43% (OR = 0.57, 95% CI: 0.47–0.68) and 31% (OR = 0.69, 95%CI: 0.58–0.82) respectively. Conclusion This study demonstrates a considerable attempt to assess the types and the prevalence of DD among preschool children in Egypt. Perinatal factors are among the most common determinants of DD in preschool children and the majority could be preventable risk factors.

Dengue fever is considered as an emerging disease in Afghanistan. Since the first outbreak was reported in 2019, other outbreaks have been reported in the following years. The current study aims to describe the epidemiological features and clinical manifestations of suspected and confirmed cases of dengue fever detected by the National Disease Surveillance and Response (NDSR) Department of the Ministry of Public Health (MoPH) during 2021 and 2022 to prevent further spread and minimize its impact on the country’s health system and on the limited number of health workers. Through a retrospective analysis of historical data related to suspected dengue fever cases in Afghanistan detected by the National Disease Surveillance and Response Department during 2021 and 2022, several variables were identified, including demographic characteristics, clinical features, clinical management, the outcome of infection, laboratory data, and epidemiological factors. All statistical analyses were developed using Microsoft 365 (Excel). The mean age of the 1977 reported suspected dengue fever cases was 30.4 ± 14.9 years, with males 70.7%. The epidemic curve showed a steep rise in cases in 2022, starting from week 39, with a peak reached in week 45, which was higher than that observed in 2021. The majority of cases (97.9%) were reported from Nangarhar Province, east of the country. Regarding symptoms, fever, headache, and muscle pain were expressed in nearly all cases. The reverse transcription polymerase chain reaction was positive in 379 cases out of 497 cases (76.3%). For the management of cases, 97.6% received antipyretics. Less than 5% of cases were admitted to health care units, with death reported in only two cases (case fatality rate of 0.1%). The number of suspected cases of dengue fever reported in Afghanistan was increasing. The trends for 2021 and 2022 followed almost the same pattern, with a higher peak in 2022. Understanding the epidemiological and clinical characteristics of dengue fever cases is fundamental for preparedness for upcoming seasons.

Objective A cohort study was conducted with the support of the WHO, where a standardized WHO protocol was followed to assess vaccine effectiveness (VE) against symptomatic RT‒PCR confirmed SARS‒CoV-2 infection among hospital health workers (HWs) eligible for vaccination at Al-Azhar University hospitals. Methods A WHO-supported cohort study was conducted from July 2022 through September 2023 and included 1249 HWs who were randomly selected and followed up biweekly for one year. At enrollment, nasopharyngeal (NP) and blood samples were collected from each participant and evaluated to detect SARS-CoV-2 RNA via a real-time PCR assay (QIAGEN) and for the quantitative detection of SARS-CoV-2 binding antibodies via the Roche Elecsys Anti-SARS-CoV-2 S immunoassay (Roche Diagnostics, GmbH, Germany). During follow-up, NP samples were collected from anyone who developed symptoms consistent with the WHO definition of suspected cases of SARS-CoV-2 infection. Results At enrollment, SARS-CoV-2 RNA was detected in 119/1235 (9.6%) HWs and 89% of the participants with positive RNA were asymptomatic. COVID-19-binding antibodies were detected among 1245/1248 (99.8%) HWs, and 53.2% of them had titers > 2500 U/mL, regardless of vaccination status. During follow-up, 232 participants had COVID-19 symptoms, but only 108 provided NP samples, and 18 (16.7%) of them were positive for SARS-CoV-2 RNA. No hospitalization or mortality was recordedat enrollment or during the follow-up period. The cumulative incidence of COVID-19 infection was higher among HWs with incomplete vaccination compared to unvaccinated, fully vaccinated, or those who received booster doses ( P  = 0.025). There was no significant difference in VE among HWs who were fully vaccinated or had booster doses compared with unvaccinated HWs, with adjusted VE values of 68% (95% CI -28–92%) and 64% (95% CI -170–95%), respectively ( P  = 0.106 and 0.318 respectively). The adjusted VE increased to 89% (95% CI -33–99%) among HWs with hybrid immunity compared with those who were unvaccinated with a previous COVID-19 infection ( P  = 0.082). Conclusion This study indicates that VE against symptomatic lab-confirmed SARS-CoV-2 infection was quite high with over 60% protection and was higher among HWs with hybrid immunity (immunity due to a combination of previous infection and vaccination) compared to unvaccinated HWs with previous COVID-19 infection. The findings also highlight the importance of completing the primary vaccination series against COVID-19. This study reveals a high rate of asymptomatic COVID-19, a lower rate of confirmed cases, who showed marked decrease in hospitalization and fatality rates. Real-world VE studies are essential to address several unresolved issues, such as the appropriate number of booster doses and the longevity of protection.

Background Turner syndrome (TS) is associated with a high prevalence of hearing loss (HL), significantly impacting quality of life. This study evaluates the prevalence and characteristics of HL in TS patients in Egypt compared to healthy controls. Thirty TS patients diagnosed via karyotyping were recruited from genetics clinic, Cairo University and compared to 30 age- and sex-matched healthy controls. Audiological assessments included pure-tone audiometry, tympanometry, and auditory brainstem response. Results Hearing loss prevalence was significantly higher in TS patients compared to controls. Mid-frequency sensorineural hearing loss was the most common type, followed by mixed and conductive hearing loss. Hearing loss was associated with increased otitis media and delayed puberty but showed no significant correlation with karyotype subtype. Conclusion The findings highlight the importance of early audiological screening and follow-up in TS patients to prevent communication impairments and enhance quality of life.

Background Managing COVID-19 pneumonia is, in reality, one of the biggest challenges in the history of intensive care medicine. The link between comorbidity and COVID-19 remains unclear. Worldwide, Egypt has the highest prevalence of hepatitis C virus (HCV). The study’s objectives were to assess the prevalence of chronic hepatitis C as a risk factor among COVID-19 patients and to investigate the impact of it and the prior exposure to different HCV management protocols on the clinical characteristics and outcome of COVID-19 patients. Results Of 2106 confirmed cases of COVID-19, CLD, malignancy, and chronic kidney disease were significant risk factors for death [OR (95% CI) = 2.78 (1.29–5.98), 2.72 (1.14–6.46) and 3.79 (1.39–10.36) respectively]. The mortality rate was 24.3%. A total of 99 cases (4.7%) with CLD were investigated during the study period; 69 patients (3.3%) were categorized as HCV-positive. Among the positive HCV cases, 49 patients (2.3%) received anti-hepatitis C medications. The mortality rate was 46.4% and 73.3% between HCV and non-HCV hepatic patients, respectively. Triple therapy showed a statistically significant association with a better outcome ( p value = 0.009). Conclusions In the present report, chronic liver diseases, chronic kidney disease, and malignancy were significant risk factors for mortality among COVID-19 patients. The Egyptian mass management of chronic hepatitis C may explain the favorable outcome of COVID-19 among these patients. Intervention trials are required to prove that direct-acting antivirals are effective in preventing COVID-19.