Pub Date : 2022-06-27DOI: 10.1080/20905068.2022.2075159
Eman Hamdy Basiony Darwish, A. Ramadan, W. Abdelsalam, A. Ibrahim, Nermen Mohamed Tawfiq Foda
ABSTRACT Background The COVID-19 ongoing pandemic is one of the deadliest pandemics in history. It has put a significant strain on healthcare systems and frontline healthcare workers. This study attempted to assess and develop the emergency preparedness of hospitals affiliated to Alexandria University. Methods A quasi-Aquasi-experimental design was conducted in three phases; the pre-intervention assessment using ahospital emergency response checklist, then awareness intervention was implemented to provide information on emergency preparedness followed by post-intervention assessment after asix-month period following the first phase using the same checklist. Results The pre-intervention assessment showed that four hospitals had a good overall preparedness level (75% or more preparedness level), while the rest of the hospitals (7 hospitals) demonstrated a fair overall preparedness level (50%- <75%). All the individual domains have demonstrated a good or fair to good preparedness levels except the recovery domain, which was fair, and the command and control domain, which was poor in the majority of the studied hospitals. The intervention awareness program has led to a significant statistical change in the command and control as well as human resources domain. However, the post-intervention scores of command and control domain remained poor in the majority of the studied hospitals.
{"title":"Assessment and development of hospital emergency preparedness plan in response to COVID-19 pandemic in Alexandria University Hospitals","authors":"Eman Hamdy Basiony Darwish, A. Ramadan, W. Abdelsalam, A. Ibrahim, Nermen Mohamed Tawfiq Foda","doi":"10.1080/20905068.2022.2075159","DOIUrl":"https://doi.org/10.1080/20905068.2022.2075159","url":null,"abstract":"ABSTRACT Background The COVID-19 ongoing pandemic is one of the deadliest pandemics in history. It has put a significant strain on healthcare systems and frontline healthcare workers. This study attempted to assess and develop the emergency preparedness of hospitals affiliated to Alexandria University. Methods A quasi-Aquasi-experimental design was conducted in three phases; the pre-intervention assessment using ahospital emergency response checklist, then awareness intervention was implemented to provide information on emergency preparedness followed by post-intervention assessment after asix-month period following the first phase using the same checklist. Results The pre-intervention assessment showed that four hospitals had a good overall preparedness level (75% or more preparedness level), while the rest of the hospitals (7 hospitals) demonstrated a fair overall preparedness level (50%- <75%). All the individual domains have demonstrated a good or fair to good preparedness levels except the recovery domain, which was fair, and the command and control domain, which was poor in the majority of the studied hospitals. The intervention awareness program has led to a significant statistical change in the command and control as well as human resources domain. However, the post-intervention scores of command and control domain remained poor in the majority of the studied hospitals.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"58 1","pages":"69 - 77"},"PeriodicalIF":0.9,"publicationDate":"2022-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44097456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ABSTRACT Introduction: Ill health is one of the natural phenomena that can happen to human beings at any time due to either communicable or non-communicable diseases. Tuberculosis (TB) is one of those communicable diseases caused by the bacillus Mycobacterium tuberculosis which can be transmitted through droplet nuclei while coughing, sneezing, shouting, or singing. Infection with tuberculosis negatively affects the productive segment of the economy, resulting in a reduction in national productivity. The World Health Organization (WHO) recommended early case detection, accurate diagnosis, and standardized treatment as a means to prevent new infections. In Ethiopia, detecting TB cases early, diagnosing, and treating these cases as per the guideline has been practiced for years through the Directly Observed Treatment Short-course (DOTS) program which was started in 1997. Various researches on TB treatment outcomes and their predictors have been done in Ethiopia. However, almost all of the findings vary from each other even though the country has a standardized definition of the outcomes and data aggregation tools. Moreover, none of the findings and reports showed the magnitude of successful TB treatment outcomes in the study area. Objective: This research was intended to assess the prevalence of successful TB treatment outcomes among patients enrolled in a DOTS program in the east Gojjam zone, northwest Ethiopia. Result: Eighty six percent (86%) of all cases enrolled in the DOTS program were successfully treated in the East Gojjam zone, and sex, place of residence, educational status, smear result during entry to the DOTS program, and HIV test result were factors significantly affecting successful TB treatment outcomes in the study area. Conclusion and Recommendation: The magnitude of successful TB treatment outcome of this study is low compared to the national strategic plan. It is advisable to work on the identified factors to positively affect successful TB treatment outcomes in the study area.
{"title":"Successful tuberculosis treatment outcome in East Gojjam zone, Ethiopia: cross-sectional study design","authors":"Maru Meseret Tadele, Getaye Tizazu, Habtamu Temesgen Denekew, Mulugeta Tesfa Gebeyehu","doi":"10.1080/20905068.2022.2090064","DOIUrl":"https://doi.org/10.1080/20905068.2022.2090064","url":null,"abstract":"ABSTRACT Introduction: Ill health is one of the natural phenomena that can happen to human beings at any time due to either communicable or non-communicable diseases. Tuberculosis (TB) is one of those communicable diseases caused by the bacillus Mycobacterium tuberculosis which can be transmitted through droplet nuclei while coughing, sneezing, shouting, or singing. Infection with tuberculosis negatively affects the productive segment of the economy, resulting in a reduction in national productivity. The World Health Organization (WHO) recommended early case detection, accurate diagnosis, and standardized treatment as a means to prevent new infections. In Ethiopia, detecting TB cases early, diagnosing, and treating these cases as per the guideline has been practiced for years through the Directly Observed Treatment Short-course (DOTS) program which was started in 1997. Various researches on TB treatment outcomes and their predictors have been done in Ethiopia. However, almost all of the findings vary from each other even though the country has a standardized definition of the outcomes and data aggregation tools. Moreover, none of the findings and reports showed the magnitude of successful TB treatment outcomes in the study area. Objective: This research was intended to assess the prevalence of successful TB treatment outcomes among patients enrolled in a DOTS program in the east Gojjam zone, northwest Ethiopia. Result: Eighty six percent (86%) of all cases enrolled in the DOTS program were successfully treated in the East Gojjam zone, and sex, place of residence, educational status, smear result during entry to the DOTS program, and HIV test result were factors significantly affecting successful TB treatment outcomes in the study area. Conclusion and Recommendation: The magnitude of successful TB treatment outcome of this study is low compared to the national strategic plan. It is advisable to work on the identified factors to positively affect successful TB treatment outcomes in the study area.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"58 1","pages":"60 - 68"},"PeriodicalIF":0.9,"publicationDate":"2022-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49569914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-07DOI: 10.1080/20905068.2022.2062958
A. Feizi, F. Haghighatdoost, P. Zakeri, A. Aminorroaya, M. Amini
ABSTRACT Introduction The current study aimed to investigate whether the pattern of changes in lipid profile and fasting blood sugar (FBS) can predict the future risk of type 2 diabetes mellitus (T2DM) incidence in prediabetic people. Methods In a prospective cohort study, 1228 prediabetic patients were followed from 2003 until 2019 and longitudinal data on lipid indices (CHOL: cholesterol; HDL: high-density lipoprotein; LDL: low-density lipoprotein; TG: triglyceride) and fasting blood sugar (FBS) were recorded. The latent class growth model (LCGM) was used to estimate growth trajectories and to determine distinct subgroups (latent class) with a similar trajectory for lipid profile and FBS over time. The incidence of T2DM in extracted latent classes was compared. Results Finally, 946 people with complete data were included in statistical analysis. Two latent classes were identified based on the change in FBS including high-risk and low-risk classes (class size: 5.2% vs. 94.8%) with T2DM incidence rates 100% and 35.9%, respectively (P < 0.001). Two distinct subgroups were identified based on changes in lipid profile. Latent classes with abnormal TG, CHOL, HDL, and LDL included 18.8%, 21.8%, 38.8%, and 24% of study participants, respectively. The incidence rates of T2DM and remaining prediabetic in abnormal TG latent class were 57.2% and 30.8%, and in abnormal HDL latent class were 41.5% and 31.7% were significantly different from normal latent classes (P < 0.001). While in the extracted latent classes based on CHOL and LDL the incidence rates were not statistically significant differences (P > 0.05). Conclusions We identified two subgroups with high and low risk of future T2DM based on the changes in FBS and lipid profile by applying LCGM. The incidence of T2DM in extracted latent classes was significantly different. LCGM is a reliable approach for predicting the risk of T2DM incidence based on trajectories of risk factors.
{"title":"Growth trajectories in lipid profile and fasting blood sugar in prediabetic people over a 16- year follow-up and future risk of type2 diabetes mellitus: A latent growth modeling approach","authors":"A. Feizi, F. Haghighatdoost, P. Zakeri, A. Aminorroaya, M. Amini","doi":"10.1080/20905068.2022.2062958","DOIUrl":"https://doi.org/10.1080/20905068.2022.2062958","url":null,"abstract":"ABSTRACT Introduction The current study aimed to investigate whether the pattern of changes in lipid profile and fasting blood sugar (FBS) can predict the future risk of type 2 diabetes mellitus (T2DM) incidence in prediabetic people. Methods In a prospective cohort study, 1228 prediabetic patients were followed from 2003 until 2019 and longitudinal data on lipid indices (CHOL: cholesterol; HDL: high-density lipoprotein; LDL: low-density lipoprotein; TG: triglyceride) and fasting blood sugar (FBS) were recorded. The latent class growth model (LCGM) was used to estimate growth trajectories and to determine distinct subgroups (latent class) with a similar trajectory for lipid profile and FBS over time. The incidence of T2DM in extracted latent classes was compared. Results Finally, 946 people with complete data were included in statistical analysis. Two latent classes were identified based on the change in FBS including high-risk and low-risk classes (class size: 5.2% vs. 94.8%) with T2DM incidence rates 100% and 35.9%, respectively (P < 0.001). Two distinct subgroups were identified based on changes in lipid profile. Latent classes with abnormal TG, CHOL, HDL, and LDL included 18.8%, 21.8%, 38.8%, and 24% of study participants, respectively. The incidence rates of T2DM and remaining prediabetic in abnormal TG latent class were 57.2% and 30.8%, and in abnormal HDL latent class were 41.5% and 31.7% were significantly different from normal latent classes (P < 0.001). While in the extracted latent classes based on CHOL and LDL the incidence rates were not statistically significant differences (P > 0.05). Conclusions We identified two subgroups with high and low risk of future T2DM based on the changes in FBS and lipid profile by applying LCGM. The incidence of T2DM in extracted latent classes was significantly different. LCGM is a reliable approach for predicting the risk of T2DM incidence based on trajectories of risk factors.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"58 1","pages":"52 - 59"},"PeriodicalIF":0.9,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48433297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-29DOI: 10.1080/20905068.2022.2067678
A. Odeyemi, Y. Olasinde, A. Ojewuyi, A. Odeyemi, O. Ala, E. Agelebe
ABSTRACT Introduction Long-lasting insecticidal nets (LLINs) are the most widely used vector control interventions for preventing malaria transmission. The study sought to determine the regular use of LLIN, factors associated with the usage and the effect of regular LLIN utilization on the development of malaria among under-five children. Methods This was a hospital-based cross-sectional observation study. We enrolled consecutive caregivers with their children aged 6 to 59 months who presented with fever in the absence of a localizing sign. A structured questionnaire was used to obtain information about the level of utilization of LLIN. Malaria parasitemia was detected using the P. falciparum rapid diagnostic test kit and/or microscopic examination of blood. Results A total of 303 children/caregivers pair was studied. The mother’s mean (SD) age was 37.17 (6.75) years, while the children was 24.36 (16.63) months. The majority (183; 60.4%) of the children were male. Parental awareness of LLIN was high (96.7%), LLIN ownership was 72.3%, however, only 119 (39.3%) were regular user of LLIN. Factors significantly associated with regular LLIN use were younger age, parental awareness, ownership of LLIN, source of acquisition of LLIN and permanently hanging the LLIN on sleeping space (p = 0.031, 0.010, 0.000, 0.006 and 0.000 respectively). Using binary logistic regression, the child’s age, source of LLIN and hanging the LLIN permanently on the bed remained statistically significant to the regular use of LLIN (p = 0.046, 0.035 and 0.000 respectively). The frequency of malaria was significantly higher among the children who did not use and those who uses LLIN irregularly (97.1% versus 32.9%, p = 0.000). Conclusions Regular use of LLIN is low in the study area. Hanging the insecticidal bed-net permanently on the bed/sleeping space promotes its regular usage. The frequency of malaria was reduced among the children using the LLIN regularly.
{"title":"Utilization of long lasting insecticidal net among children aged less than five years in a tertiary health facility in south-west Nigeria","authors":"A. Odeyemi, Y. Olasinde, A. Ojewuyi, A. Odeyemi, O. Ala, E. Agelebe","doi":"10.1080/20905068.2022.2067678","DOIUrl":"https://doi.org/10.1080/20905068.2022.2067678","url":null,"abstract":"ABSTRACT Introduction Long-lasting insecticidal nets (LLINs) are the most widely used vector control interventions for preventing malaria transmission. The study sought to determine the regular use of LLIN, factors associated with the usage and the effect of regular LLIN utilization on the development of malaria among under-five children. Methods This was a hospital-based cross-sectional observation study. We enrolled consecutive caregivers with their children aged 6 to 59 months who presented with fever in the absence of a localizing sign. A structured questionnaire was used to obtain information about the level of utilization of LLIN. Malaria parasitemia was detected using the P. falciparum rapid diagnostic test kit and/or microscopic examination of blood. Results A total of 303 children/caregivers pair was studied. The mother’s mean (SD) age was 37.17 (6.75) years, while the children was 24.36 (16.63) months. The majority (183; 60.4%) of the children were male. Parental awareness of LLIN was high (96.7%), LLIN ownership was 72.3%, however, only 119 (39.3%) were regular user of LLIN. Factors significantly associated with regular LLIN use were younger age, parental awareness, ownership of LLIN, source of acquisition of LLIN and permanently hanging the LLIN on sleeping space (p = 0.031, 0.010, 0.000, 0.006 and 0.000 respectively). Using binary logistic regression, the child’s age, source of LLIN and hanging the LLIN permanently on the bed remained statistically significant to the regular use of LLIN (p = 0.046, 0.035 and 0.000 respectively). The frequency of malaria was significantly higher among the children who did not use and those who uses LLIN irregularly (97.1% versus 32.9%, p = 0.000). Conclusions Regular use of LLIN is low in the study area. Hanging the insecticidal bed-net permanently on the bed/sleeping space promotes its regular usage. The frequency of malaria was reduced among the children using the LLIN regularly.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"58 1","pages":"44 - 51"},"PeriodicalIF":0.9,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45007135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-25DOI: 10.1080/20905068.2022.2064164
Randa Salah Eldin Abdelmoneim Ibrahim, Amr Aly Abdelmoety, N. Baddour, P. Salem, M. Metawea
ABSTRACT Background Portal hypertensive gastropathy (PHG) is an overlooked complication of liver cirrhosis, as it is a source of acute upper gastrointestinal bleeding and cause of chronic blood loss. Objective To assess the role of narrow band endoscopy in the diagnosis of PHG in cirrhotic patients. Methods Fifty patients with liver cirrhosis were examined by both conventional White Light Endoscopy (WLE) and Narrow Band Technology Variable Intelligent Staining Technology (VIST) using Sonoscape endoscope HD500. Biopsies were taken from the body of gastric mucosa during endoscopy. Results The prevalence of PHG among patients with liver cirrhosis is around 94% by WLE, 92% by VIST, and 55.3% by pathology. There is no statistical significance between VIST and WLE in case of PHG p = 0,750. The risk of developing oesophageal varices grade 3 in severe PHG is higher than in no or mild PHG (OR = 6.8571, 95% CI 1.6270 to 28.9001, p = 0.0087). Conclusion VIST is comparable and complementary to WLE in diagnosis of PHG. There is poor correlation between pathology and WLE in diagnosis of PHG.
{"title":"Narrow band endoscopic diagnosis of portal hypertensive gastropathy in cirrhotic patients","authors":"Randa Salah Eldin Abdelmoneim Ibrahim, Amr Aly Abdelmoety, N. Baddour, P. Salem, M. Metawea","doi":"10.1080/20905068.2022.2064164","DOIUrl":"https://doi.org/10.1080/20905068.2022.2064164","url":null,"abstract":"ABSTRACT Background Portal hypertensive gastropathy (PHG) is an overlooked complication of liver cirrhosis, as it is a source of acute upper gastrointestinal bleeding and cause of chronic blood loss. Objective To assess the role of narrow band endoscopy in the diagnosis of PHG in cirrhotic patients. Methods Fifty patients with liver cirrhosis were examined by both conventional White Light Endoscopy (WLE) and Narrow Band Technology Variable Intelligent Staining Technology (VIST) using Sonoscape endoscope HD500. Biopsies were taken from the body of gastric mucosa during endoscopy. Results The prevalence of PHG among patients with liver cirrhosis is around 94% by WLE, 92% by VIST, and 55.3% by pathology. There is no statistical significance between VIST and WLE in case of PHG p = 0,750. The risk of developing oesophageal varices grade 3 in severe PHG is higher than in no or mild PHG (OR = 6.8571, 95% CI 1.6270 to 28.9001, p = 0.0087). Conclusion VIST is comparable and complementary to WLE in diagnosis of PHG. There is poor correlation between pathology and WLE in diagnosis of PHG.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"58 1","pages":"38 - 43"},"PeriodicalIF":0.9,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48448403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-14DOI: 10.1080/20905068.2022.2057146
A. Odeyemi, K. Olufemi-Aworinde, A. Odeyemi, O. Oni, Y. Olasinde, J. Akande
ABSTRACT Introduction Pulmonary complications with the subsequent lung function abnormalities occur commonly among sickle cell disease (SCD) patients even while at their steady states. This study, therefore, aimed to determine the prevalence and pattern of lung function abnormalities and its associated factors among SCD patients. Methods This was a hospital-based cross-sectional study in a Nigerian tertiary hospital involving 113 SCD participants and age- and gender-matched non-SCD controls. Spirometry, transthoracic echocardiography, oxygen saturation, complete blood count, serum urea and creatinine were done for the participants. Results The forced vital capacity, forced expiratory volume in 1 second and the peak expiratory flow rate of the SCD participants were significantly lower than that of the control group with p-values of 0.004, 0.000 and 0.000 respectively. Of the SCD participants; 40.7% recorded abnormal lung function with the restrictive pattern occurring most commonly with a prevalence of 28.3%. There was a statistically significant relationship between age and lung function of the SCD participants (p = 0.044). Conclusion Lung function abnormalities occur frequently among people with SCD with the restrictive pattern being the most common abnormality and these abnormalities occur more frequently as these patients age.
{"title":"Lung function abnormalities in patients with sickle cell disease in a Nigerian tertiary health centre","authors":"A. Odeyemi, K. Olufemi-Aworinde, A. Odeyemi, O. Oni, Y. Olasinde, J. Akande","doi":"10.1080/20905068.2022.2057146","DOIUrl":"https://doi.org/10.1080/20905068.2022.2057146","url":null,"abstract":"ABSTRACT Introduction Pulmonary complications with the subsequent lung function abnormalities occur commonly among sickle cell disease (SCD) patients even while at their steady states. This study, therefore, aimed to determine the prevalence and pattern of lung function abnormalities and its associated factors among SCD patients. Methods This was a hospital-based cross-sectional study in a Nigerian tertiary hospital involving 113 SCD participants and age- and gender-matched non-SCD controls. Spirometry, transthoracic echocardiography, oxygen saturation, complete blood count, serum urea and creatinine were done for the participants. Results The forced vital capacity, forced expiratory volume in 1 second and the peak expiratory flow rate of the SCD participants were significantly lower than that of the control group with p-values of 0.004, 0.000 and 0.000 respectively. Of the SCD participants; 40.7% recorded abnormal lung function with the restrictive pattern occurring most commonly with a prevalence of 28.3%. There was a statistically significant relationship between age and lung function of the SCD participants (p = 0.044). Conclusion Lung function abnormalities occur frequently among people with SCD with the restrictive pattern being the most common abnormality and these abnormalities occur more frequently as these patients age.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"58 1","pages":"31 - 37"},"PeriodicalIF":0.9,"publicationDate":"2022-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46213105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-09DOI: 10.1080/20905068.2021.2010450
S. A. Moosavi, Behnam Hasannejad-Asl, Masoumeh Kourosh Arami, Mahsa Nasuti, M. C. Oğuz, Abdolhosein Naseri
ABSTRACT Background Mosaic genetic anomaly is a problematic and interpretative issue in prenatal diagnosis. Conventional karyotyping, as a confirmatory test traditionally used for detecting mosaic and nonmosiac prenatal disorders. Recently Quantitative Fluorescence PCR (QF-PCR) is used for prenatal testing. We retrospectively assessed the frequency of both mosaic and nonmosaic conditions in a large-scale study and compared the clinical value of confirmatory cytogenetic analysis with QF-PCR and other screening tests. Result Of 6033 cases identified as abnormal conditions by sonography or protein marker screening tests, only 180 nonmosaic and 8 mosaic cases confirmed to be abnormal by confirmatory karyotyping test results. The cytogenetic analysis was correlated with other QF-PCR confirmatory test results for nonmosiac conditions but it was not comparable for mosaic cases. Conclusion The cytogenetic analyses were shown to have the greatest clinical value in revealing the various mosaic conditions. The QF-PCR test is shown to be a reliable confirmatory test for nonmosaic diseases but not for mosaicism, and the screening protein marker test can weakly indicate the presence of abnormal cell lines. Moreover, older mothers (>30 years) are at greater risk for developing mosaic ova.
{"title":"Confirmatory test versus screening test analyses for fetal mosaic variations; a large scale study","authors":"S. A. Moosavi, Behnam Hasannejad-Asl, Masoumeh Kourosh Arami, Mahsa Nasuti, M. C. Oğuz, Abdolhosein Naseri","doi":"10.1080/20905068.2021.2010450","DOIUrl":"https://doi.org/10.1080/20905068.2021.2010450","url":null,"abstract":"ABSTRACT Background Mosaic genetic anomaly is a problematic and interpretative issue in prenatal diagnosis. Conventional karyotyping, as a confirmatory test traditionally used for detecting mosaic and nonmosiac prenatal disorders. Recently Quantitative Fluorescence PCR (QF-PCR) is used for prenatal testing. We retrospectively assessed the frequency of both mosaic and nonmosaic conditions in a large-scale study and compared the clinical value of confirmatory cytogenetic analysis with QF-PCR and other screening tests. Result Of 6033 cases identified as abnormal conditions by sonography or protein marker screening tests, only 180 nonmosaic and 8 mosaic cases confirmed to be abnormal by confirmatory karyotyping test results. The cytogenetic analysis was correlated with other QF-PCR confirmatory test results for nonmosiac conditions but it was not comparable for mosaic cases. Conclusion The cytogenetic analyses were shown to have the greatest clinical value in revealing the various mosaic conditions. The QF-PCR test is shown to be a reliable confirmatory test for nonmosaic diseases but not for mosaicism, and the screening protein marker test can weakly indicate the presence of abnormal cell lines. Moreover, older mothers (>30 years) are at greater risk for developing mosaic ova.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"58 1","pages":"8 - 17"},"PeriodicalIF":0.9,"publicationDate":"2022-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45688881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-09DOI: 10.1080/20905068.2021.2024349
A. Elbasha, Y. Naga, Mai Othman, Nancy Diaa Moussa, Hala Sadik Elwakil
ABSTRACT Introduction Acute intradialytic complications remain a major burden in end stage renal disease (ESRD) patients on hemodialysis (HD). They often lead to early termination of the HD session affecting dialysis adequacy and patient overall health. The aim of the study was to create an artificial intelligence model and to assess its performance in the prediction of the occurrence of intradialytic clinical events. Methods We studied 6000 HD sessions performed for 215 ESRD patients, recording many predictors that included: patient, machine, and environmental factors. These data were collected within 24 weeks, including 12 weeks in the COVID 19 era and were used to develop and train an artificial neural network model (ANN) to predict the occurrence of intradialytic clinical events such as: hypotension, headache, hypertension, cramps, chest pain, nausea, vomiting, and dyspnea. Findings Our ANN model showed mean precision and recall of 96% and AUC of 99.3% in binary ANN to predict occurrence of an intradialytic complication (event or no event), while the accuracy of the categorical ANN in predicting the type of event was 82%. We found that heart rate changes, mean systolic pressure, ultrafiltration rate, dialyzate sodium, meal, urea reduction ratio, room humidity and dialysis session duration most strongly influence occurrence of an intradialytic complication. Discussion Our ANN model can be used to predict the risk of intradialytic clinical events among HD patients and can support decision-making for healthcare in the frequently under-staffed dialysis units, especially in COVID 19 era.
{"title":"A step towards the application of an artificial intelligence model in the prediction of intradialytic complications","authors":"A. Elbasha, Y. Naga, Mai Othman, Nancy Diaa Moussa, Hala Sadik Elwakil","doi":"10.1080/20905068.2021.2024349","DOIUrl":"https://doi.org/10.1080/20905068.2021.2024349","url":null,"abstract":"ABSTRACT Introduction Acute intradialytic complications remain a major burden in end stage renal disease (ESRD) patients on hemodialysis (HD). They often lead to early termination of the HD session affecting dialysis adequacy and patient overall health. The aim of the study was to create an artificial intelligence model and to assess its performance in the prediction of the occurrence of intradialytic clinical events. Methods We studied 6000 HD sessions performed for 215 ESRD patients, recording many predictors that included: patient, machine, and environmental factors. These data were collected within 24 weeks, including 12 weeks in the COVID 19 era and were used to develop and train an artificial neural network model (ANN) to predict the occurrence of intradialytic clinical events such as: hypotension, headache, hypertension, cramps, chest pain, nausea, vomiting, and dyspnea. Findings Our ANN model showed mean precision and recall of 96% and AUC of 99.3% in binary ANN to predict occurrence of an intradialytic complication (event or no event), while the accuracy of the categorical ANN in predicting the type of event was 82%. We found that heart rate changes, mean systolic pressure, ultrafiltration rate, dialyzate sodium, meal, urea reduction ratio, room humidity and dialysis session duration most strongly influence occurrence of an intradialytic complication. Discussion Our ANN model can be used to predict the risk of intradialytic clinical events among HD patients and can support decision-making for healthcare in the frequently under-staffed dialysis units, especially in COVID 19 era.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"58 1","pages":"18 - 30"},"PeriodicalIF":0.9,"publicationDate":"2022-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48566804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-03-08DOI: 10.1080/20905068.2021.2009652
F. Elkhamisy, A. H. Zidan, M. Fathelbab
ABSTRACT Achieving high levels of integration in the basic medical sciences’ curricula is challenging. Project-based learning (PtBL) is an inquiry-based learning approach that can be used in multiple educational contexts with various designs. We used PtBL to enhance curricular integration during the pre-clerkship years. The study was done at The Faculty of Medicine, Helwan University, Cairo, Egypt. We designed interdisciplinary clinically relevant integrated research project tasks. Tasks followed curricular objectives. Students worked in teams to write and deliver project reports. Based on their understanding of the basic medical sciences, they analyzed the assigned tasks and used reasoning to create diagnoses. They related the condition to the disrupted normal structure/functions, suggested/contraindicated specific treatment and preventive plans. A cross-sectional survey was introduced to assess students’ perceptions of the learning approach used. Response rate was 52% (n = 694). Students’ responses were analyzed. Most students (84.6%) were satisfied by the integrated interdisciplinary PtBL. They (57.9%) preferred substituting the traditional lectures completely by it. Students understood the relation between objectives of disciplines after PtBL completion (mean 3.66, SD ±0.92) higher than before it (mean 3.46, SD ±0.91), (P = 0.000). Students’ ranking for the degree of integration between basic/clinical sciences in the PtBL was significantly associated with the developed clinical reasoning rank (P = 0.000). It was also associated with responses supporting the future implementation of the PtBL again (P = 0.002). Various ways of adding PtBL approach to the curricula were suggested. The PtBL can be used as a complementary learning method to elevate the level of integration within a multidisciplinary approach to boost students’ learning.
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Pub Date : 2021-01-01DOI: 10.1080/20905068.2021.1911110
A. Niraula, M. Lamsal, R. Maskey
Dear Sir,COVID-19 and Diabetes Mellitus (DM) have been reported to be one of the lethal cocktails [1]. COVID-19 infection in diabetic patients has shown to progress to more severe form and can lead...
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