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Bacterial resistance to widely used antibiotics is an emerging global health issue and causes a huge problem in burn patients. Despite important developments in antimicrobial treatments, the risk of infection-associated mortality rate in burn patients is comparatively high. Escherichia coli is one of the most common causative agents of burn wound infections. Therefore, this study aimed to identify and characterize E. coli isolates from burn wounds using the VITEK 2 system and to test their antibiotic resistance to the most commonly used antibiotics with the disc diffusion method. In our study, of 147 clinical samples obtained from burn patients, 25 (%17) were detected as positive for E. coli. All these isolates were found to be resistant to cephalothin, cephradine, piperacillin, and rifampin antibiotics. The resistance to amoxicillin+clavulanic acid and ampicillin was 96% (± 8%), which was followed by amikacin and cefotaxime with a 92% (± 11%) resistance rate. On the other hand, imipenem (96% ± 8%), tetracycline (88% ± 13%), and gentamicin (76% ± 17%) were the antibiotics that showed the highest sensitivity against E. coli isolates. The multidrug-resistant bacteria are one of the main issues for clinical applications, so their characterization is vital in developing a proper treatment strategy. This study concluded that E. coli exists in burn wounds and might cause wound infection due to its resistance to different antibiotics. [ABSTRACT FROM AUTHOR]

Background: Egypt is one of the highest countries in the world regarding the prevalence of hepatitis C virus (HCV) infection. End stage renal disease (ESRD) patients are at higher risk for HCV infection more than general population. Since 2014 Egypt has started a large elimination program for screening and treatment of HCV. Goal was early detection and treatment of HCV patients. Intending HCV prevalence reduction to<2% in 10 years, in line with global targets. In addition, Egypt has aimed to treat 250000 people annually up to 2020 in the first phase of their treatment program aiming at reducing the number of viremic patients, thus limiting the ongoing HCV transmission. Aim of the Work: to measure the prevalence of HCV infection among ESRD patients and to identify the reasons of missed treatment among those who were offered the treatment free of charge. Patients and Methods: This multi-center cross sectional study included 410 patients receiving hemodialysis sessions on regular basis 4 hours/3 times per week for more than 6 months in Ain Shams University Hospitals, patient recruitment from March 2023 to August 2023. Results: Our studied 410 patients had mean age of 47.13 ± 18.19 ranging between 18 - 85 years old with male predominance (62.4%). With different educational levels. Most of them had comorbidities (85.6%), as HTN (54.1%) being most predominant. Prevalence of HCV infection is (27.6%), Among patients with HCV infection, (84.1 %) received treatment and (15.9%) didn't receive treatment due to several causes. The patients with positive HCV infection had a lower educational level than negative HCV infection with a statistically significant difference (P = 0.027). The patients with positive HCV PCR had a prolonged onset of renal function impairment than negative HCV PCR with a statistically highly significant difference (P = 0.009), and also positive HCV PCR had prolonged dialysis duration and a prolonged duration of HCV infection than negative HCV PCR with a statistically significant difference. Conclusion: The low prevalence of HCV among hemodialysis patients of HCV in hemodialysis patients confirms that HCV infection doesn't become a major health problem among patients on maintenance hemodialysis. However, strict adherence to effective and proper procedures for controlling hepatitis infections will warrant preventing and reducing the prevalence of hepatitis infections. Clinically, hemodialysis patients require more attention and resources than the general population. [ABSTRACT FROM AUTHOR]

Background: Hepatitis C Hepatitis C virus (HCV) infection is one of the most commonly reported viral infections in both developing and developed countries, causing significant mortality and morbidity and costing billions of dollars annually. The prevalence of HCV infection in hemodialysis patients varies substantially among different geographical regions. Recent studies have shown that the HCV prevalence in hemodialysis patients varies from 1.4%-28.3% in developed countries and 4.7%-41.9% in developing countries Aim of the Work: to estimate the prevalence of HCV infection and to determine the seroconversion rate in prevelant hemodilaysis in Kafr Elsheikh governorate after the hepatitis C virus infection National eradication program in Egypt and to identify the demographics leading to then non-compliance to hepatitis C virus medications and missed follow up among the prevalent hemodialysis patients with HCV infection in Kafr EL sheikh governorate, Egypt. Patients and Methods: All patients were assessed for eligibility criteria and were included in the study only when they had met the following inclusion criteria: age older than 18 years old, maintained on regular hemodialysis session for more than 3 months. On the other hand, the exclusion criteria encompassed patients with acute kidney injury or any conditions necessitating temporary dialysis or patient age is less than 18 years old. 1162 prevalent hemodialysis patients in kafr el sheikh governorate, Egypt have been enrolled at our cross sectional study (multi-centric study) applying the proposed standards of the inclusion and exclusion criteria of our study design. Results: Among these 1162 patients, 403 patients (34.68%) had history of positive PCR for HCV infection prior and during the national eradication campaign. Among those patients, 212 patients (52.61%) received HCV infection treatment in the form of oral and parenteral medications, while 191 patients (47.39%) didn't receive treatment. Among the patients who didn't receive the prescribed medications for HCV virus, 107 patients (56.02%) had concerns about drug complications, 22 patients didn't receive the prescribed medication due to lack of counselling while 20 patients (10.47%) did not receive treatment due to other causes as being mentally retarded, or having advanced medical comorbidities as advanced liver disease or decompensated heart failure while 42 patients (21.99%) refused to receive treatment without giving reasons. Conclusion: The prevalence of HCV infection among the studied prevalent hemodialysis patients in Kafr El-Sheikh governorate is 19.4% after the HCV national eradication protocol and can be considered a major health problem. A significant percentage of the prevalent hemodialysis patients with hepatitis C virus infection refused to apply to the prescribed antiviral medications or being non complaint on medication that was mostly due to fear of developed major side effects of the prescribed medications and lack of counselling. [ABSTRACT FROM AUTHOR]

Background: Egypt has aimed to treat 250000 people annually up to 2020 in the first phase of their treatment program aiming at reducing the number of viremic patients, thus limiting the ongoing HCV transmission. Egypt is struggling to eliminate HCV and HCV-related morbidity by 2030. Aim and Objectives: to measure the frequency rate of HCV infection among ESRD patients and identify the reasons of un-treatment among those who were offered the treatment free of charge. Subjects and Methods: This multi-center cross sectional study included 500 patients receiving hemodialysis sessions on regular basis for more than 3 months in Dakahlia Governorate, patient recruitment from November 2022 to April 2023. Result: According to patients' medical history we found that, 23.4% of patients had previous HCV infection from them 12.6% received treatment and 10.8% didn't receive treatment due to several causes as one patient didn't know about the drug availability, five patients (1%) fear from occurrence of side effects, 43 patients (8.6%) didn't need treatment and five patients (1%) had other causes as had contraindication of drugs, non-compliance and deterioration of health status. Also, 20.4% of patients had been informed that they completely recovered and 0.8% had recurrence. After investigations, 1% of patients had positive HbsAg, 23.4% had positive HCV Ab, 4.2% positive HCV PCR. Conclusion: The low prevalence of HCV among hemodialysis patients of HCV in HD patients confirm that HCV infection doesn't become a major health problem among patients on maintenance HD. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease (CKD) is a growing worldwide epidemic. The incidence and prevalence of end-stage renal disease (ESRD) are expected to continue to increase. The most recent United States Renal Data System (USRDS) reports indicate that the incident dialysis population has grown older, has more comorbid conditions than previous years, and is starting dialysis with higher levels of residual kidney function (RKF). Aim of the Work: This study was done to evaluate the current status of home hemodialysis in the Middle East, then to study the perspectives and future possibilities of home hemodialysis in Egypt. It was carried out during the last 2 years; 2019 and 2020. It included 2 parts: Patients and Methods: A retrospective and prospective study on 100 patients that was randomly selection and was adult ESRD patients (age > 18 years) either were treated and maintained on home hemodialysis during the last 5 years or will be treated and maintained on home hemodialysis during the period from march 2019 to march 2020. Results: HD patients with volume overload or those with cardio-renal syndrome were found to better tolerate excessive UF with the use of home HD machines than that with the usual in-center machines. SLED and SCUF modes were very effectively managed with the use of these simple HD machines. It was noticed that the loss of residual renal functions in new HD patients, was significantly less with the use of home HD than with the usual in-center HD. This was related to less dialysate exposure other than the use of ultrapure dialysate. Conclusion: The psychological status was significantly improved in those patients with having their sessions at their homes without any added stressors related to in-center HD. Even new ESRD patients who are too reluctant to start HD, were better convinced to start home HD. Home HD is a gentle and benign mode of HD with less reported intra-dialytic complications; attributed to the use of ultrapure dialysate solutions other than the treated tap/well water used in center HD. [ABSTRACT FROM AUTHOR]

Introduction: Contrast induced acute kidney injury (CI-AKI) is known to be a complication of using intravascular contrast injection. Unfortunately, It is associated with adverse outcomes as prolonged length of hospitalization and increased burden of health care costs. So, we aimed to determine the efficacy of febuxostat in prevention of contrast induced acute kidney injury among patients with chronic kidney disease Stage 3 performing percutaneous coronary intervention (PCI). Methods: In a randomized controlled trial we enrolled 120 CKD stage 3 Patients with acute coronary syndrome referred to the cardiology department Ain-Shams University hospital for performing PCI and stenting. Patients were randomly assigned to two arms: Group I (study group): Included 60 patients who received Febuxostat added to the traditional treatment (IV hydration and N-acetylcysteine). The patients received Feburic 80 mg within 6- 18 hours before and within 6-18 hours after the coronary intervention (a time gap of 24 hours between two doses).Group II (control group): included 60 patients who received only traditional treatment. Results: The incidence of AKI was higher in the control group with a statistically significant difference. We found that Independent Significant risk factors that led to AKI were febuxostate avoidance, DM, high urea level, high creatinine level, CKD stage 3B, high Mehran score and high AKI risk. Conclusion: We demonstrated that febuxostat has a renoprotective effect and it can help to reduce the incidence CI-AKI in CKD patients stage 3 performing PCI. [ABSTRACT FROM AUTHOR]

Introduction: Hepatitis C virus (HCV) infection is strongly associated with chronic kidney disease (CKD). It is an independent risk factor for developing CKD and significantly increases morbidity and mortality in CKD patients. Treatment with newer direct-acting antiviral (DAA) regimens in patients with CKD is showing conflicting results as regards safety and efficacy. Objectives: To evaluate the safety and efficacy of DAAs and their impact on kidney function in CKD patients. Patients and Methods: We conducted a prospective observational study on 100 CKD patients stages 3-4, receiving treatment for HCV at MASRI (Faculty of Medicine Ain Shams University Research Institute), with two different DAAs regimens (sofosbuvir/daclatasvir with or without ribavirin and ombitasvir/paritaprevir/ritonavir [OMV/PTV/RTV] with ribavirin), completed over six months follow up. Serum creatinine, estimated glomerular filtration rate (eGFR), and proteinuria were followed during and after treatment. Results: Sustained virological response (SVR) was achieved in all patients. Improvement of eGFR (8-15 mL/min/1.73 m2) and proteinuria was found in both study groups. Acute kidney injury (AKI) was uncommon; it occurred in three (3%) patients, out of them, two patients showed complete recovery. Adverse events were common (43%), but serious adverse events were uncommon (2%). Conclusion: DAA regimens were effective and well-tolerated for HCV infected patients with stage 3-4 CKD, where viral clearance caused improvement in eGFR and proteinuria. [ABSTRACT FROM AUTHOR]

Background: Matrix Gla protein (MGP) acts as a potent local inhibitor of vascular calcification. However, to be active, MGP must be phosphorylated and carboxylated; such carboxylation is vitamin K-dependent, and phosphorylation is necessary for the secretion of MGP. This study aimed to investigated the effect of vitamin K2 on MGP levels after 3 months’ supplementation and the relationship between MGP level and vascular stiffness in hemodialysis patients. Patients and methods: This interventional, double armed, clinical trial (Single-blinded) study was conducted in the dialysis Unit in Al-Ahrar Teaching Hospital, Sharkia on 48 end-stage renal disease (ESRD) patients on regular hemodialysis divided into 2 groups; 24 patients receiving Mk -7 as 90 mcg/day and 24 patients receiving placebo. Carotid duplex ultrasound for right and left common carotid arteries was done to assess Peak Wave Velocity (PWV) and the presence or absence of atheromatous plaques, prior to administering MK-7 and again after 3 months, for both groups. Results: There was statistically nonsignificant difference between the studied groups regarding hemoglobin, serum calcium, phosphorus, potassium, sodium, alkaline phosphatase, Ktv and parathyroid hormone. There was statistically non-significant difference between the studied groups regarding baseline matrix Gla protein. There was statistically significant difference between the studied groups regarding matrix Gla protein after 3 months of administration of vitamin k2 supplementation and placebo within intervention and placebo groups respectively. Conclusions: Vitamin k2 supplementation to hemodialysis patients will reduce ucMGP, which in turn reduces calcification and stiffness of blood vessels and cardiovascular system which in turn reduces cardiovascular morbidity and mortality. [ABSTRACT FROM AUTHOR]

In the first phase of its treatment program, Egypt aimed to treat 250,000 people annually until 2020, thereby reducing the number of viremic patients and limiting hepatitis C virus (HCV) transmission. Egypt strives to eradicate HCV and HCV-associated morbidity by 2030. This study aimed to determine the prevalence of HCV infection among end-stage renal disease patients and the reasons for non-treatment among those offered free medication. This multi-center cross-sectional study was conducted during the period from November 2022 to April 2023. The study included 500 patients receiving hemodialysis (HD) sessions on a regular basis for more than three months in Dakahlia Governorate. According to patients` medical history, we found that 23.4% of patients had previous HCV infection. Of these, 12.6% received treatment, and 10.8% did not receive treatment due to a variety of reasons. For instance, some patients were unaware of the drug's availability, five patients (1%) feared side effects, 43 patients (8.6%) did not require treatment, and five patients (1%) had other causes as contraindications of drugs, noncompliance and deterioration of health status. In addition, 20.4% of patients were reported to have fully recovered, while 0.8% had a recurrence. After investigations, 1% of patients had positive hepatitis B surface antigen (HbsAg), 23.4% positive HCV Ab, and 4.2% positive HCV by the polymerase chain reaction. In conclusion, the low prevalence of HCV among HD patients confirms that HCV infection is not currently a significant health concern among patients on maintenance HD., (Copyright© by the Egyptian Association of Immunologists.)