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Introduction “Delayed discharge” is defined as patients who remain hospitalised beyond the time of being fit for discharge after a decision of discharge has been made by the managing team. There is no standardised amount of time defining delayed discharge documented in the literature, and there is a lack of evidence about this topic in Egypt. This study is a quality improvement project aiming to identify the factors associated with discharge delays at a single centre in Egypt in order to address this issue. Methods A prospective observational study included all trauma patients admitted to a University Hospital in Egypt over two months. The time of the decision of discharge and actual discharge time were recorded by reviewing patients' medical records. The patients and their caregivers were asked to fill in a questionnaire about the reasons for delayed discharge. Potential reasons for the delayed discharge were classified into system-related, medical and family-related factors. Results The study included 498 patients with a median age of 41 years (9–72). The median time from discharge decision until actual discharge was 3 h. System-related factors were documented in 48.8% of cases, followed by medical factors (36.3%), and family-related factors (28.1%). When controlling for age, gender and injury severity score using a logistic regression analysis, longer time to discharge (≥3 h) showed a stronger association with medical factors [adjusted OR (95% CI) = 5.44 (2.73–10.85)] and family-related factors [adjusted OR (95% CI) = 7.94 (3.40–18.54)] compared to system-related factors [adjusted OR (95% CI) = 2.20 (1.12–4.29)]. Discussion Although system-related factors were more prevalent, medical and family-related factors appear to be associated with longer discharge delays compared to system-related factors.

Background: Hepatocellular carcinoma (HCC) is considered as the third leading cause of cancer-related deaths, in spite of great advances in its treatment. The carbohydrate polymers, exopolysaccharides (EPSs), showed anticancer activity in diverse cancers. Objective: The purpose of this study is to investigate a panel of 43 apoptotic proteins to assess the possible apoptotic induction effect of bacterial EPSs showing promising cytotoxic effects in HepG2 cells in our previous study, in an attempt to introduce exopolysaccharides as new source for cancer treatment. Materials and Methods: Apoptosis-related proteins panel were examined through the analysis of Human Apoptosis Antibody Array-Membrane (43 targets). Results: EPS-6 induces apoptosis through upregulation of different pro-apoptotic proteins as cytochrome C (9.52 fold) and tumor necrosis factor-related apoptosis-inducing ligand receptor (TRAIL-R1) (153.49 fold). EPS-RS induces apoptosis through up regulation of second mitochondria-derived activator of caspases (SMAC) (15.75 fold) and the six insulin-like growth factors binding proteins (IGFBP-1 through – 6) (76.81 fold, 7.68 fold, 55.15 fold, 4.9 × 107 fold, 29.69 fold, and 28.92 fold), respectively. Conclusion: Our results suggested that EPS-6 and EPS-RS could be considered as promising agents in hepatocellular carcinoma treatment.

This study carried out to detect a adhesion genes (icaA and ica D) among orthopedic patients showing prosthetic joint infection in Helmia Armed Forces Hospital. The hip and knee aspirate samples (49) were collected from (patients showing infected prosthesis). Understand conditions and transfer rapidly to the lab. Notes: (5) sample were negative control means total (54) samples. The aim of this study to detect biofilm formation and also detect some genes (icaA, icaD) which are responsible for biofilm formation. and gene expression The material and methods The samples were cultured on blood Agar medium then the isolates were cultured on Conog Red. Agar medium to detect biofilm formation. Molecular detection carried out: firstly DNA was extracted from bacterial isolates, RNA was also extracted and was used as template for real time PCR (qRCR) by light cycler (Roch) PCR, syber green as fluorescent dye. Reverse transcriptase was done, specific primers were used for icaA and icaD to transfere RNA into cDNA genes 16rSRNA was used as reference control. The results The results showed that 67% of the samples (hip and knee aspirates) were biofilm formation (black colonies +ve biofilm) red colonies (-ve) biofilm formation. The results showed that in hip aspirate samples) (4) out of (28) 14.8% were positive for both (icaA, icaD) and positive for biofilm formation. In knee aspirate sample (5) out of (21) 28.5% were positive for both (icaA and icaD) and positive for biofilm formation, in current study. The phenotype (biofilm formation) don't correlate with the presence of icaA, icaD. The gene expression was evaluated with the presence of mRNA (icaA, icaD) for example, in current study (hip aspirate samples) (4) out of (28) 14.2% and negative for biofilm formation (phenotype). In knee isolates samples (3) out of (21) were negative for icaA and icaD but positive phenotype. Conclusion: biofilm bacteria is difficult to eradicate and it causes catastrophic problem for prosthetic infected orthopedic patients. There are some factors lead to biofilm formation genes basically and the environment, the surface of biomaterial. The presence, the concentration of some substances like: glucose, iron, phenols, limited oxygen. The genes expression of icaA, icaD is proportional with amount of mRNA of these genes

Lactobacilli can be introduced as probiotics because of their health-promoting characteristics and non-pathogenic nature. This study aimed to perform the isolation, molecular identification, and probiotic characterization of Lactobacillus to find candidate strains isolated from unpasteurized milk of Cow and samples of young calves ileum with probiotic activity. Forty- two isolates were obtained. Of these, 5 Lactobacillus strains belonging to five species (L. paraplantarum strain S143, L. pentosus strain P2-3, L. plantarum strain J12, L. gasseri strain F. and L. reuteri strain IRT) were identified. They demonstrated remarkable results such as resistant to simulated gastric juices with pepsin and simulated small intestinal juice with pancreatin, susceptible to some antibiotics, good antimicrobial activity and strong adhesion to Caco-2 cell line that candidate them as potential probiotics. Moreover, the compatibility between the five selected starins was tested and there was no antagonism found between them.