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Background Schistosomiasis, also known as bilharzia, is the second important parasitic disease after malaria. The present study aimed to evaluate the molluscicidal effects of silver nanoparticles on Biomphalaria alexandrina, B. glabrata, Oncomelania hupensis, snail intermediate hosts of intestinal schistosomes (i.e. Schistosoma mansoni and S. japonicum), along with the changes their antioxidant enzymes. Methods Silver (Ag) nano powder (Ag-NPs) was selected to test the molluscicidal effects on three species of freshwater snails. Exposure to Ag-NPs induced snail mortality and the LC.sub.50 and LC.sub.90 values of Ag-NPs for each snail species were calculated by probit analysis. Control snails were maintained under the same experimental conditions in dechlorinated water. Snail hemolymph was collected to measure the levels of antioxidant enzymes, such as total antioxidants capacity (TCA), glutathione (GSH), catalase (CAT) and nitric oxide (NO). In addition, the non-target organism, Daphnia magna, was exposed to a series of Ag-NPs concentration, similar to the group of experimental snails, in order to evaluate the LC.sub.50 and LC.sub.90 and compare these values to those obtained for the targeted snails. Results The results indicated that Ag-NPs had a molluscicidal effect on tested snails with the variation in lethal concentration. The LC.sub.50 values of Ag-NPs for B. alexandrina snails exposed for 24, 48, 72 hrs and 7 days were 7.91, 5.69, 3.83 and 1.91 parts per million (ppm), respectively. The LC.sub.50 values for B. glabrata snails exposed for 24, 48, 72 hrs and 7 days were 16.55, 10.44, 6.91 and 4.13 ppm, respectively, while the LC.sub.50 values for O. hupensis snails exposed for 24, 48, 72 hrs and 7 days were 46.5, 29.85, 24.49 and 9.62 ppm, respectively. Moreover, there is no mortality detected on D. magna when exposed to more than double and half concentration (50 ppm) of Ag-NPs during a continuous period of 3 hrs, whereas the LC.sub.90 value for B. alexandrina snails was 18 ppm. The molluscicidal effect of the synthesized Ag-NPs seems to be linked to a potential reduction of the antioxidant activity in the snail's hemolymph. Conclusions Synthesized Ag-NPs have a clear molluscicidal effect against various snail intermediate hosts of intestinal schistosome parasites and could potentially serve as next generation molluscicides.

Thais savignyi Deshayes (Muricidae) is widely distributed in the Red Sea. Its abundance and the history of Muricidae in traditional medicine make it a tempting target for investigation. To investigate the chemical profile and biological activities of T. savignyi tissue extracts. Methanol, ethanol, acetone, and ethyl acetate extracts from T. savignyi tissue were compared in their antioxidant by total antioxidant capacity, DPPH free radical scavenging, and total phenolic content. In addition, the antimicrobial, and antibiofilm properties (at 250 µg/mL) of the extracts were tested against Escherichia coli, Pseudomonas aeruginosa, Proteus vulgaris, Klebsiella pneumoniae, Staphylococcus aureus, and Candida albicans. The antioxidant extract with greatest activity was assessed for cytotoxicity (range 0.4-100 µg/mL) against 3 human cancer cell lines (UO-31, A549 and A431), and its chemical composition was investigated using GC-MS. Moreover, docking simulation was performed to predict its constituents' binding modes/scores to the active sites of thymidylate kinase. The ethyl acetate extract (Ts-EtOAc) showed the highest total antioxidant capacity (551.33 mg AAE/g dry weight), total phenolics (254.46 mg GAE/g dry weight), and DPPH scavenging (IC 50 = 24.0 µg/mL). Ts-EtOAc exhibited strong antibacterial (MIC: 3.9 µg/mL against K. pneumoniae), antibiofilm (MIC: 7.81 µg/mL against S. aureus), and antifungal (MIC: 3.9 µg/mL against C. albicans) activities and considerable cytotoxicity against cancer cells (UO-31: IC 50 = 19.96 ± 0.93, A549: IC 50 = 25.04 ± 1.15 μg/mL). GC-MS identified multiple bioactive metabolites in Ts-EtOAc extract belonging to miscellaneous chemical classes. Molecular docking studies revealed that the constituents of Ts-EtOAc have antibacterial potential. T. savignyi extract has considerable antimicrobial and cytotoxic activities. Further studies are needed to isolate the active constituents of this snail for comprehensive drug discovery tests.

Continuous field studies on the abundance and distribution of freshwater snails and cercarial populations are important for schistosomiasis control programs. In the present work, snail surveys and cercariometry were conducted for four successive seasons at 12 sites on the Nile River banks in the area of Greater Cairo to identify potential transmission foci for schistosomiasis. In addition, water physicochemical parameters were recorded. The results showed that the electrical conductivity, total dissolved solids, dissolved oxygen, and pH were within the permissible levels, except that the water temperature increased, especially in the spring season. Malacological surveys identified 10 native snail species at the studied sites of the Nile River, namely  Bulinus truncatus, Biomphalaria alexandrina, Lymnaea natalensis, Lanistes carinatus, Cleopatra bulimoides, Melanoides tuberculata, Helisoma duryi, Bellamya unicolor, Physa acuta, Thedoxus niloticus,  and one invasive snail species,  Thiara scabra . The calculated diversity index indicated that the structure of snails’ habitats was poor, while Evenness index indicated that the individuals were not distributed equally. Natural infection results identified no schistosome cercariae in  B. truncatus  and  B. alexandrina . However, the cercariometry recovered  Schistosoma  cercariae in all the surveyed sites during all seasons with variable distribution. The preceding data suggest that there are still some active transmission foci for schistosomiasis infection in the Nile River. Moreover, the present finding highlights the importance of cercariomety as a complementary approach to snail samplings for identifying the transmission foci for schistosomiasis.

Background: CT techniques and procedures have been expanded in the past decades, leading to an increase in the use of CT. At the same time, the radiation dose to the patient and the concern surrounding this issue has also increased. Objectives: The goal of this study was to assess clinical image quality and x-ray dose from various computed tomography (CT) scanners in order to identify the CT scanners that produce the least radiation dose to patients with exact acceptable image quality for diagnosis. Patients and Methods: Non-randomized clinical image data were collected from six hospitals on 16, 32 and 64 slice CT scanners. A total of 900 patients who underwent chest, abdomen, and brain scans were used for image quality evaluation and dose assessment. The image qualities were evaluated by five observers on 1 - 5 visual grading scale. The CT dose volume index (CTDIv) and dose length product (DLP) was documented from the image display. Results: The averaged CTDIv was 64.96, 70.2, and 75 mGy for the brain, 11.65, 15.53 and 17.11 mGy for the chest, and 13.41, 18.44, and 19.42 mGy for the abdomen from 16, 32 and 64 slice scanners respectively. The averaged image quality scores were 3.68, 3.82, and 4.81 for the abdomen, 3.01, 4.27, and 4.42 for the chest, and 4.92, 4.94, and 4.99 for the brain from 16, 32 and 64 slice scanners respectively. Conclusion: Sixteen slice CT scanner delivered the minimum radiation dose to patients in contrast with the 32 and 64 slice CT scanners, and the image quality was adequate for diagnosis. Both 32 and 64 slice CT scanners produced more than acceptable image quality as well as more than needed dose to patients. The patient dose from the 32 and 64 slice scanners may be reduced by dropping their image quality to close to the 16 slice CT scanner.

Cardiac arrest is defined by a lack of central pulse, unresponsiveness, and apnea, indicating the termination of effective mechanical heart activity. Although rare in pediatrics, it results in poor outcomes. Results concerning the survival rates of pediatrics after cardiopulmonary resuscitation (CPR) in Jordan are absent, making this study crucial knowledge for implication of hospital protocol. A retrospective study was conducted at a tertiary hospital in Jordan. This study included 411 pediatric patients, aged over one day to under 12 years, who underwent CPR either during an emergency department (ED) visit or during hospitalization. The Mann-Whitney -test, Chi-Square test, and Fisher's exact tests were used for analysis. Survival-associated factors were analyzed using univariate and multivariate logistic regression, and p < 0.05 was considered significant. Patients were separated into a less than one year age group and a greater than one year age group, with similar gender distributions. Survival was significantly associated with age; the survivors were older than the non-survivors. Furthermore, the presence of any neurological manifestation was associated with a higher risk of mortality with an odds ratio of 3.97 (95% CI: 1.46-10.86, p = 0.007). After adjusting for all covariates, each 1% rise in oxygen saturation increased the adjusted odds ratio (AOR) of survival (AOR = 1.08, 95% CI 1.01-1.15; p = 0.031). In the same model, every additional minute of CPR sharply decreased the likelihood of survival (AOR = 0.38, 95% CI 0.21-0.72; p = 0.003). The survival rates after CPR in pediatrics were poor overall, suggesting a need for better pediatric CPR strategies and further studies. Many factors could affect the outcomes, most importantly, the duration of CPR and the oxygen saturation.

Objectives. To assess the impact of live interactive telecardiology on diagnosis and disease management, patients’ quality of life, and time- and cost-savings. Methods. All consecutive patients who attended or were referred to the teleclinics for suspected cardiac problems in two hospitals in remote areas of Jordan during the study period were included in the study. Patients were interviewed for relevant information and their quality of life was assessed during the first visit and 8 weeks after the last visit. Results. A total of 76 patients were included in this study. Final diagnosis and treatment plan were established as part of the telecardiology consultations in 71.1% and 77.3% of patients, respectively. Patients’ travel was avoided for 38 (50.0%) who were managed locally. The majority of patients perceived that the visit to the telecardiology clinic results in less travel time (96.1%), less waiting time (98.1%), and lower cost (100.0%). Telecardiology consultations resulted in an improvement in the quality of life after two months of the first visit. Conclusions. Telecardiology care in remote areas of Jordan would improve the access to health care, help to reach proper diagnosis and establish the treatment plan, and improve the quality of life.

Background Schistosomiasis, also known as bilharzia, is the second important parasitic disease after malaria. The present study aimed to evaluate the molluscicidal effects of silver nanoparticles on Biomphalaria alexandrina, B. glabrata, Oncomelania hupensis, snail intermediate hosts of intestinal schistosomes (i.e. Schistosoma mansoni and S. japonicum), along with the changes their antioxidant enzymes. Methods Silver (Ag) nano powder (Ag-NPs) was selected to test the molluscicidal effects on three species of freshwater snails. Exposure to Ag-NPs induced snail mortality and the LC50 and LC90 values of Ag-NPs for each snail species were calculated by probit analysis. Control snails were maintained under the same experimental conditions in dechlorinated water. Snail hemolymph was collected to measure the levels of antioxidant enzymes, such as total antioxidants capacity (TCA), glutathione (GSH), catalase (CAT) and nitric oxide (NO). In addition, the non-target organism, Daphnia magna, was exposed to a series of Ag-NPs concentration, similar to the group of experimental snails, in order to evaluate the LC50 and LC90 and compare these values to those obtained for the targeted snails. Results The results indicated that Ag-NPs had a molluscicidal effect on tested snails with the variation in lethal concentration. The LC50 values of Ag-NPs for B. alexandrina snails exposed for 24, 48, 72 hrs and 7 days were 7.91, 5.69, 3.83 and 1.91 parts per million (ppm), respectively. The LC50 values for B. glabrata snails exposed for 24, 48, 72 hrs and 7 days were 16.55, 10.44, 6.91 and 4.13 ppm, respectively, while the LC50 values for O. hupensis snails exposed for 24, 48, 72 hrs and 7 days were 46.5, 29.85, 24.49 and 9.62 ppm, respectively. Moreover, there is no mortality detected on D. magna when exposed to more than double and half concentration (50 ppm) of Ag-NPs during a continuous period of 3 hrs, whereas the LC90 value for B. alexandrina snails was 18 ppm. The molluscicidal effect of the synthesized Ag-NPs seems to be linked to a potential reduction of the antioxidant activity in the snail’s hemolymph. Conclusions Synthesized Ag-NPs have a clear molluscicidal effect against various snail intermediate hosts of intestinal schistosome parasites and could potentially serve as next generation molluscicides. Author summary Schistosomiasis is one of the major parasitic diseases with socio-economic and health importance in the developing world. Control of snail intermediate hosts of human schistosomes is an essential part of the program on fighting schistosomiasis. This study evaluated the effect of silver nanoparticles (Ag-NPs) on the snail intermediate hosts of Schistosoma mansoni, i.e. Biomphalaria alexandrina, B. glabrata, and the intermediate host of S. japonicum, i.e. Oncomelania hupensis. The results revealed that LC50 values of Ag-NPs against B. alexandrina, B. glabrata and O. hupensis were 7.91, 16.55 and 46.5 ppm, respectively, after 24 hrs of exposure. The results also revealed that O. hupensis snails tolerate better the toxic effect of Ag-NPs than B. alexandrina and B. glabrata snails. We also demonstrated that the freshwater crustacean Daphnia magna tolerate even higher concentration of Ag-NPs compared to the three species of snail intermediate hosts of schistosomes. Experiments on exposure of B. alexandrina to the sub-lethal concentration (LC25) of Ag-NPs obviously altered the antioxidant enzymes in the snail’s hemolymph. From the aforementioned results, Ag-NPs exhibited a promising molluscicidal activity against the snail intermediate hosts of human schistosomes, could eventually be used in the national schistosomiasis control program.

Background: Information is the foundation for policymaking, planning, programming, and accountability. Health informatics is the intersection of information science, computer science, and health care. It deals with the resources, devices, and methods optimizing the acquisition, storage, retrieval, and use of information in health and biomedicine. Most professionally run hospitals and clinics now rely on Hospital \"or Healthcare\" Information Management Systems (HIMS) that help them manage all their medical and administrative information. Objective: to execute and test the design, implementation and evaluation of a HIMS and testing the application in a Heliopolis, Cairo- based hospital. Methodology: Data for this study were collected by the use of different tools to address five key areas: 1. An analysis of the need for a HIMS. 2. Benefits of HIMS 3. Analysis of data of hospital health workers perceptions towards implementation of HIMS 4. Testing and application of HIMS in pediatrics- related departments 5. Suggestions for selecting and improvement of HIMS. Results: Although they want more training on the use of the system, more computers and timely information, health workers perceptions indicate their satisfaction with the ease of use of HIMS and that it is important in many ways for the smooth running of the hospital. Conclusion: HIMS has significant direct and indirect benefit to patient service quality and the development of organizational capabilities for linking strategy formulation and implementation, process improvement, decision- making, medical, and epidemiological research/reporting and performance feedback. Although problems can be identified during the process of using HIMS, the benefits outweigh the difficulties, thereby justifying their use.