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Hepatic and gastrointestinal disturbances in Egyptian patients infected with coronavirus disease 2019: A multicentre cohort study

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World Journal of Gastroenterology 2021年第40期27卷 6951-6966页

作者： Hend ibrahim Shousha Shimaa Afify Rabab Maher Noha Asem Eman Fouad Ehab F Mostafa Mohammed A Medhat Amr Abdalazeem Hazem Elmorsy miriam M Aziz Rateba S Mohammed Mohamed Ibrahem Hassan Elgarem Dalia Omran Mohamed Hassany Bassem Elsayed Ahmed Y Abdelaziz Mohamed El Kassas Endemic Medicine Faculty of MedicineCairo UniversityCairo 11562Egypt Gastroenterology Department National Hepatology&Tropical Medicine Research InstituteCairo 11563Egypt Hepatology Department Students HospitalCairo UniversityGiza 12566Egypt The Public Health Department Faculty of MedicineCairo UniversityCairo 11562Egypt Egyptian Ministry of Health and PopulationCairo 11567Egypt Department of Tropical Medicine and Gastroenterology Faculty of MedicineAssiut UniversityAssiut 15655Egypt Endemic Medicine Department Faculty of MedicineHelwan UniversityCairo 13544Egypt Internal Medicine 15 Mayo Smart HospitalMinistry of Health and PopulationCairo 13488Egypt Pediatrics Department Faculty of MedicineCairo UniversityCairo 11562Egypt Occupational and Environmental Medicine Department Faculty of MedicineCairo UniversityCairo 11562Egypt Clinical Biochemistry Department Faculty of medicineCairo UniversityCairo 11562Egypt Endemic Medicine Department Faculty of MedicineCairo UniversityCairo 11562Egypt Urology Department Cairo UniversityCairo 11562Egypt

BACKGROUND Various liver and gastrointestinal involvements occur in patients with coronavirus disease 2019(COVID-19)at variable *** studies report mild liver function disturbances correlated with COVID-19 severity,though liver failure is *** To study liver and gastrointestinal dysfunctions in Egyptian patients with COVID-19 and their relation to disease outcomes METHODS This multicentre cohort study was conducted on 547 Egyptian patients from April 15,2020 to July 29,*** polymerase chain reaction-confirmed COVID-19 cases were included from four quarantine hospitals affiliated to the Egyptian ministry of *** information,laboratory characteristics,treatments,fibrosis-4(FIB-4)index,COVID-19 severity,and outcomes were recorded and compared according to the degree of liver enzyme elevation and the presence of gastrointestinal ***-ups were conducted until discharge or *** analyses were performed to determine the independent factors affecting *** This study included 547 patients,of whom 53(9.68%)died during hospitalization and 1 was discharged upon his ***’mean age was 45.04±17.61 years,and 21.98%had severe or critical *** aminotransferase(ALT)and aspartate aminotransferase(AST)were available for 430 and 428 patients,*** total,26%and 32%of patients had elevated ALT and AST,*** liver injury with ALT or AST elevation exceeding 3-fold was recorded in 21(4.91%)and 16(3.73%)patients,*** gender,smoking,hypertension,chronic hepatitis C,and lung involvement were associated with elevated AST or *** was elevated in 50%of patients over ***-4 was significantly higher in patients admitted to the intensive care unit(ICU),those with more severe COVID-19,and *** independent variables affecting outcome were supplementary vitamin C intake(1 g daily capsules)[odds ratio(OR):0.05,95%confidence interval(CI

关键词： COVID-19 Egypt Liver injury Gastrointestinal symptoms Fibrosis-4 Liver enzymes

Comparative Study of the Effects of Metformin and Garlic Extract on Hippocampal Na+/K+ATPase, Ca2+ATPase and Glutamine Synthetase Activities in Type II Diabetic Wistar Rat

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Journal of Biomedical Science and Engineering 2018年第9期11卷 254-262页

作者： Abass Alao Safiriyu ibrahim Semuyaba Sodiq Kolawole Lawal Muhammad Olanrewaju Buhari Emmanuel Ayikobua Tiyo Muhamudu Kalange Alfred Omachonu Okpanachi miriam Nansunga Department of Physiology Faculty of Biomedical SciencesKampala International UniversityIshakaUganda Department of Anatomy St.Francis University College of Health and Applied SciencesIfakaraTanzania Department of Anatomy Faculty of Biomedical SciencesKampala International UniversityIshakaUganda Department of Physiology Faculty of Biomedical SciencesSt.Augustine International UniversityKampalaUganda

Diabetes mellitus has not ceased to be on rise in spite of the continuous research on its management. Brain dysfunction associated with Diabetes mellitus especially Type II has been the great concern. The aim of this study was to investigate the effect of insulin sensitizing drug metformin and ethanolic extract of garlic on membrane bound enzymes Na+/K+ ATPase, Ca2+ ATPase and glutamate-glutamine cycle enzyme, Glutamine Synthetase activities in the hippocampus of streptozotocin-Nicotinamide induced Type II Diabetic rats. Twenty four male wistar rats weighted 120 - 150 g were used and divided into four groups with six rats in each group. Group A was non-diabetic (Control) and Groups B, C and D were diabetic. Group B received no treatment (DNT) while Groups C and D were treated with 1000 mg/kg of ethanolic garlic extract (EGE) and 50 mg/kg of metformin (MET) respectively orally for three weeks. All the groups were fed on standard rat chow with water ad libitum. Blood glucose was monitored weekly. Animals were sacrificed and the brains were removed and hippocampi were carefully excised and homogenate were obtained. Homogenate was analyzed for Na+/K+ ATPase, Ca2+ ATPase and Glutamine Synthetase (GS) activities. MET and EGE significantly reduced the blood glucose levels. There was a significant increase in the activities of hippocampal Na+/K+ ATPase, Ca2+ ATPase and GS in MET and EGE when compared to DNT. The results suggest that both MET and EGE increase the activities of hippocampal Na+/K+ ATPase, Ca2+ ATPase and GS which were reduced by diabetes mellitus, thus garlic and metformin administration exhibiting neuroprotective effect during hippocampal-related disorders associated with diabetes mellitus.

关键词： ATPase Diabetic Mellitus Garlic Glutamine Synthetase Hippocampus Metformin Na+/K+ ATPase

Community Education Challenges in Young Adults of South Western Uganda

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Open Journal of Epidemiology 2015年第1期5卷 65-70页

作者： Keneth Iceland Kasozi Isaac Echoru Elvis Ngala Mbiydzenyuy Aaron Kimwise miriam Nansunga ibrahim Semuyaba Muhamudu Kalange Herbert Izo Ninsiima Kintu Muggaga Simon Peter Emorut Department of Medical Physiology Faculty of Biomedical Sciences Kampala International University Western Campus Bushenyi Uganda Department of Medical Anatomy Faculty of Biomedical Sciences Kampala International University Western Campus Bushenyi Uganda Department of Computing Faculty of Science and Technology Kampala International University Western Campus Bushenyi Uganda Department of Public Health Faculty of Allied Health Kampala International University Western Campus Bushenyi Uganda

The aim of this study was to identify the major challenges to community education and any health problem in Bushenyi district of South Western Uganda. Data collection was done through questionnaire and participants were randomly selected. This was a cross-sectional study carried out for a period of three months in 2012. A questionnaire was used to collect data and using onsite observations the responses were validated. A total of 260 participants from 65 homesteads were included in the study from 52 households. 144 were females and 116 males, of which 52.4% of the children were female and the rest male. The mean ± SEM age of females and males was 36 ± 8.6 and 29 ± 8.6 years respectively. In all the homesteads, 71% were headed by an adult male and only 29% were found to be headed by an adult female while none was headed by children. Inferential analysis showed (P = 0.02) that there are more females than male in the homesteads. Majority of the homesteads are being taken care of by women instead of men probably as a result of the high mortalities due to HIV/AIDS in the past decade and above all the movement of most men to urban centers in search of better sources of employment to support their families. Among school going age participant’s i.e. children and adolescents, only 59.6% were found to be attending school. There was no statistical significance (P = 0.16) between school attendance and age. Family responsibilities such as cooking for younger siblings by female participants, obligations on open market days are thought to be secondary limiting factors for community development and livelihood amongst young persons;thus a follow up study would be conducted to assess their associations in this community as this would raise major child abuse concerns which would need to be reported to the legal authorities for follow up.

关键词： Community Education in Uganda Children Education in Sub-Saharan Uganda Medical Students Rural Education Rural Public Health

针刺不同穴组治疗广泛性焦虑症疗效的比较研究

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针刺不同穴组治疗广泛性焦虑症疗效的比较研究

作者：易卜拉欣（ibrahim Zeyad Ali Khattab）北京中医药大学

学位级别：硕士

研究背景每个人都会定期经历恐惧和焦虑的情绪。恐惧,是精神、身体以及行为对外部威胁的一种即刻反应;焦虑是一种紧张不安的情绪,这种情绪给人带来痛苦和不快,但其成因尚不明确。焦虑症一词来自于拉丁语单词“ango”,意思是使人窒息或... 详细信息

研究背景每个人都会定期经历恐惧和焦虑的情绪。恐惧,是精神、身体以及行为对外部威胁的一种即刻反应;焦虑是一种紧张不安的情绪,这种情绪给人带来痛苦和不快,但其成因尚不明确。焦虑症一词来自于拉丁语单词“ango”,意思是使人窒息或令人沮丧。焦虑情绪的发作和潜在威胁之间没有明确的时间先后关系。焦虑感可能作为一种预感出现在威胁发生之前,并一直持续到威胁结束之后;也可能在没有明确威胁的情况下出现。焦虑症通常伴随着身体和行为的变化,这一点类似于由恐惧带来的身体和行为的变化。广泛性焦虑症(GAD)是一种以六个月或更长时间的慢性过度夸张的焦虑和紧张为特征的疾病,表现为无缘由的过度焦虑和紧张,比绝大部分人所经历过的普通焦虑更加严重。GAD患者通常对未来抱有最坏的打算,他们过分担心金钱、健康、家庭、工作,即使并没有迹象表明事情会出问题,他们也无法放松,常常患有失眠症。焦虑的原因有时难以确定,可能仅仅是想到如何熬过这漫长的一天就会引起焦虑感。许多GAD患者伴有身体上的症状,例如疲劳、战栗、肌肉紧张、头痛、烦躁或潮热,他们可能会感到头晕眼花或呼吸困难,也可能感到恶心或经常必须去洗手间。GAD最常见于儿童期或青春期,但也有可能成年后发作。与男性相比,它对女性的影响更大。GAD的发生可能存在家族遗传因素,也可能因为压力过大而使得GAD程度加重。GAD通常与抑郁症,药物滥用及其他焦虑症并存。肠易激综合征通常伴随GAD一同出现,尽管它多发于酗酒、严重抑郁或具有恐慌症的人群,尽管其具体成因尚不明确。针灸是经由世界卫生组织(WHO)批准的GAD治疗手段。许多研究表明,针灸对此类病症疗效显著,因此针灸可以作为GAD患者一种不错的治疗选择。研究目的:本研究旨在评价针灸治疗广泛性焦虑症(GAD)的疗效。研究方法该研究是在以色列东耶路撒冷的Rayan补充医学中心(Salah el din 25 Salah Al-din St#20 East Jerusalem,Israel)进行的。40位具有焦虑症症状的患者被分为了两组症状包括:心悸、紧张、胸部不适或有压迫感,因焦虑而时常会感到心跳骤停。一组将通过针刺足三里(ST36)、三阴交(SP6)、合谷(LI4)、曲池(LI11)和列缺(LU7)这些穴位进行治疗,以上穴位的选择引用自miriam Lee博士的《高级针灸师的见解:穴位的组合可以治疗多种疾病》一书。另一组将通过针刺百会(DU20)、四神聪(EX-HN1)、上星(DU23)、内关(PC6)、合谷(LI4)、足三里(ST36)、三阴交(SP6)、太冲(LR3)和丰隆(ST40)这些穴位进行治疗,以上穴位的选择引用自石学敏教授的《针灸学》一书。在接受治疗后的第一周、第三周、第六周和第八周,患者被要求完成《精神障碍诊断和统计手册》(DSM Ⅳ)的焦虑筛选调查GAD-7和可视化模拟评分量表VFAS。第一次就诊时,在记录相关病史后,所有具有GAD确诊标准的患者被招募进本次研究。在之后的四天里,根据本研究的入选和排除标准对这些患者进行了筛选,最终确定符合所有条件的患者,并随机分为两组。同时,还要求患者报告其症状和感觉,其中患者报告有心悸、躁动不安、疲劳、注意力不集中、忧虑、肌肉紧张和睡眠障碍(难以入睡或嗜睡、或不安定的睡眠)。随机性:在一张纸上列出所有入选的患者(n=40);患者被随机分为第一组(n=20)和第二组(n=20)。随后通过简单的抽签,确定第一组将接受根据石学敏《针灸学》一书所给出的穴位进行针灸治疗,这些穴位是:百会(DU20)、四神聪(EX-HN1)、上星(DU23)、内关(PC6)、合谷(LI4)、足三里(ST36)、三阴交(SP6)、太冲(LR3)和丰隆(ST40)。第二组将接受根据miriam Lee博士的书目《高级针灸师的见解:穴位的组合可以治疗多种疾病》中所给出穴位进行针灸治疗:足三里(ST36)、三阴交(SP6)、合谷(LI4)、曲池(LI11)和列缺(LU7)。GAD是基层医疗中最常见的焦虑症。针灸,作为补充和替代药物疗法,已经普及并被接受为医学疗法。它是中医药(TCM)的重要组成部分。近年来,一些西方国家使用针灸治疗常见疾病的人数急剧增加。本研究的目的在于比较两组穴位治疗GAD的疗效。选择以上穴位,一方面是因为以上穴位是我的国家针灸临床上常用的穴位,除此以外,我还依照中医理论,根据穴位功能和部位在本次研究中选择穴位。在miriam Lee的书中,我们观察到使用足三里(ST36)、合谷(LI4)、三阴交(SP6)、曲池(LI11)和列缺(LU7)来治疗许多疾病,这是我选择这些将这个穴组与石学敏在焦虑一章中提到的针刺穴组进行对照的主要原因。百会穴(DU20)是督脉、足太阳膀胱经、足少阳胆经、手少阳三焦经以及足厥阴肝经的交汇点,它入络脑,具有调节脑髓及脑功能

关键词：针灸焦虑症广泛性焦虑症心悸