Background: Coagulopathy and thromboembolic events are common in patients and are poor prognostic factors. Controversy exists regarding the potential of anticoagulation (AC) to reduce mortality and incidence of thromboembolic events in Covid-19 patients. The current systematic review and meta-analysis investigated the association between anticoagulants and mortality in adult hospitalized COVID-19 patients using the available published non-randomized studies. Methods: Google Scholar, PubMed, Scopus, the Cochrane Library and Clinical Trials.gov were searched for relevant studies. A meta-analysis of adjusted and unadjusted estimates was performed. The relative risk was used as a measure of effect. The random-effects model was used to pool estimates using the generic inverse variance method.Results: Sixteen studies were included in the quantitative data synthesis. Results showed a statistically significant association between AC and mortality (RR ¼ 0.56, 95% CI 0.36; 0.92, p ¼ 0.02). Both therapeutic (Relative risk [RR] ¼ 0.4, 95% CI 0.27; 0.57) and prophylactic AC (RR ¼ 0.54, 95% CI 0.41; 0.71) were associated with lower risk of mortality. Pre-admission AC was not associated with mortality (RR ¼ 0.84, 95% CI 0.49; 1.43, p > 0.05) while prophylactic AC was associated with higher risk of mortality compared to therapeutic AC (RR ¼ 1.58, 95% CI 1.34; 1.87, p < 0.001). Conclusion: Findings support the association of AC with mortality in Covid-19 patients. The results, synthesized from mostly low-quality studies, show that prophylactic and therapeutic AC might reduce mortality in Covid-19 patients.Findings suggest that therapeutic doses might be associated with better survival compared to prophylactic doses.

Background and Aim: Q fever is considered a neglected zoonotic disease and is caused by Coxiella burnetii. Very little information is available on C. burnetii infections in cattle, sheep, and goat populations in Egypt. The aim of this study was to identify the seroprevalence of C. burnetii in humans and livestock and to test for the presence of C. burnetii DNA in sera from seropositive animals and humans. Materials and Methods: Blood samples were collected from 160 apparently healthy farm animals and 120 patients from three hospitals of the Assiut Governorate throughout 2017/2018. These populations were tested for antibodies against C. burnetii phase II antigen by immunofluorescence assay [IFA]) and enzyme-linked immunosorbent assay (ELISA). Seropositive samples were subjected to real-time quantitative polymerase chain reaction (RT-qPCR). Results: The results of the IFA revealed C. burnetii seroprevalence rates of 45.3%, 56.0%, 45.7%, and 53.3% in cattle, sheep, goats, and humans, respectively. In humans, the seroprevalence rates were 52.1%, 30.4%, 37.5%, 74.1%, and 62.5% in patients with fever of unknown origin, influenza, kidney dialysis, hepatitis C virus, and hepatitis B virus, respectively. Likewise, by ELISA, the seroprevalence in bovine was 50.7%; sheep, 60.0%; goats, 51.4%; and humans, 55.0% (54.3%, 30.4%, 37.5%, 77.8%, and 62.5% in patients with fever of unknown origin, influenza, kidney dialysis, hepatitis C virus, and hepatitis B virus, respectively). RT-qPCR targeting the repetitive element IS1111 confirmed the presence of C. burnetii DNA. Conclusion: These results proved that apparently healthy cattle, sheep, and goats may be very important reservoirs of C. burnetii infection. In light of these data, the effect of Q fever on the replication of hepatitis virus remains unclear. Although hepatitis is one of the main aspects of acute Q fever, the influence of hepatitis on Q fever remains to be investigated. Q fever is not a reportable disease in Egypt, and clinical cases may rarely be recognized by the health-care system. Additional information on the epidemiology of C. burnetii in Egypt is warranted, including other associated problems such as the distribution of infections, pathologic hallmarks, and molecular typing.

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The present study was carried out to screen and analyze the characteristics of antibiotic resistance in Campylobacter strains isolated frompoultry and human in the poultry farms of different localities in Egypt. A total of 340 samples were taken from poultry and human from poultry farms and examined bacteriologically for isolation of Campylobacter organisms. Fifty-six (16.47%) samples were identified as Campylobacter-positive; 50 (14.71%) from poultry samples and 6(1.76%) from human samples using conventional method. The isolates were42 (12.35%) isolates for C. jejuni including 38 (12.67%) from poultry samples and4(10%) from human samples. Isolates for C. coli were 14 (4.12%) including 12 (4%) from poultry samples and 2 (5%) from human samples detected. All Campylobacter isolates were evaluated for their antibiotic susceptibilities. Results of Antibiogram revealed that Campylobacter isolates were resistant to one or more of the antibiotics tested. Resistance was most frequently observed against streptomycin (96.4%) amoxicillin (94.6%), doxycycline (87.5%), Ampicillin (83.9%), nalidixic acid (85.7%), erythromycin and ciprofloxacin (82.1%). C. jejuni strains were often resistant to cephalothin (35.7%) than C. coli strains (42.8%). C. coli were sensitive to erythromycin and Streptomycin (100%). C. jejuni was an increase sensitive to amoxicillin and streptomycin (95.2%). The trend of resistance to gentamicin (28.6%) and tetracycline (50%) was observed for C. jejuni. The present study provides an assessment of the occurrence of multidrug resistance of Campylobacter isolates from chicken samples collected from the poultry farms in different localities in Egypt. The antimicrobial resistance rates among these pathogens are clearly important in risk assessment and management. Further research is also needed to better understand the relationship between antimicrobial used in poultry and humans and the bacterial resistance in humans.

Background: The emergence of the COVID-19 pandemic has changed the delivery of medical care across the world.  The objective of the study is to understand and document the preventive steps implemented on geriatric services in the primary health care centers during COVID-19 pandemic. Design and Methods: This is a retrospective study carried on geriatric services utilization (Geriatric clinic- osteoporosis clinic – Memory and dementia clinic) in primary health care centers in Dubai Health Authority in 2020.Results: The study showed that the overall in person visits for all geriatric service in 2020 declined by almost 70%. The total number of telephone consultations in geriatric clinics, osteoporosis clinics and memory clinics were 1479, 1149 and 104 respectively. The COVID-19 pandemic had led to a reduction in most of the geriatric services including outpatient clinics, screening and referral. Telephone consultation provided a foundation for delivery of the service.Conclusion: This study reflected the potential for telehealth services to bring benefits and convenience to the geriatric population, even after the end of the pandemic.

P oultry has been reported to carry increasingly antibiotic-resistant bacteria in its digestive tract. In the past, enterococci of the gut of humans and animals were considered to be common and harmless with little or no clinical relevance (Fisher and Phillips, 2009; Marshall and Levy, 2011). Meanwhile, they are the second and third most important etiologic agents of urinary tract infections and nosocomial bacteremia in humans, respectively. In intensive care units enterococci may be found in 14.3% of patients (Papadimitriou-Olivgeris et al., 2014). The most common species isolated from clinical samples of humans are Enterococcus (E.) faecalis and E. faecium (Panesso et al., 2008). One of the main reasons that enterococci can survive in the hospital environment is their intrinsic resistance to some research Article Abstract | Little information available for the Egyptian setting. 117 cloacal swabs were collected from diseased poultry located in 6 districts in Egypt. Isolates were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). The antibiotic susceptibility testing of Enterococcus faecium and Enterococcus gallinarum isolates against 22 antibiotics was performed with the MICRONAUT system for Gram-positive bacteria. The presence of 12 resistance-associated genes (tetK, tetL, tetM, tetS, tetO, erm(B), msrC, aac6-aph2, vanA, vanB, vanC1 and mecA) was investigated by PCR. Thirty one Enterococcus isolates have been detected, Enterococcus faecium (n=22) and Enterococcus gallinarum (n=9) strains were isolated. All Enterococcus faecium and Enterococcus gallinarum isolates were multidrug-resistant. More than 15% of Enterococcus faecium isolates were resistant to vancomycin. Resistance rates to other antibiotics ranged between 31.8% for teicoplanin to 86.4% for penicillin G, respectively. Enterococcus gallinarum isolates showed a resistance rate of 100% to cefoxitin, ceftaroline, clindamycin, daptomycin, erythromycin, gentamicin and oxacillin. The resistance genes most often found were msrC, erm(B), aac6-aph2 and mecA. The vanB gene was identified in two Enterococcus faecium isolates from which one was resistant to vancomycin whereas vanC1 was detected in 6 Enterococcus faecium and Enterococcus gallinarum isolates. Tetracycline resistance-associated genes (tetK, tetL, tetM, tetO and tetS) were found in 25 isolates whereas mecA was detected in nine isolates. The study is the first report for mecA gene in Enterococcus. The development of resistance to antibiotics in poultry production needs special attention and investigation. The usage of antimicrobials in Egypt should follow WHO and OIE recommendations.

Campylobacteriosis incidence and proportion of Campylobacter strains resistant to antibiotic have been increased worldwide in the last decades. Campylobacteriosis is considered as one of the major important zoonotic gastrointestinal diseases around the world. The aim of this study was isolation and biochemical characterization of Campylobacter from poultry. Campylobacter isolation have been done on MCCDA media, motility has been detected by phase contrast microscope, morphology has been detected by Gram stain, and confirmed by MALDI-TOF MS and molecular confirmation by using cPCR by amplification of 16S rRNA gene. A total of 102 isolates of Campylobacter were isolated from farm and small backyards located in different sources in El-Kalyobia , El-Monofia and El-sharkia Governorates by conventional bacteriological methods from which 40 were C. jejuni and 62 were C. coli. All isolates have been confirmed as Campylobacter by MALDI-TOF MS and detection of 16S rRNA by cPCR. PCR is a useful molecular tool for identification and confirmation of Campylobacter. It is rapid, sensitive, and specific than the culture methods, but the only disadvantage is that is expensive.

IntroductionContagious equine metritis (CEM) was first described in the United Kingdom (UK) in 1977, and then become world-wide [1].Contagious equine metritis is an inflammatory disease of the proximal and distal reproductive tract of the mare caused by Taylorellaequigenitalis, causing mares temporary infertile [2].Taylorellaequigenitalis is a Gram-negative, microaerophiliccocco bacillus bacterium, transmitted during mating.Infected mares had a profuse, mucopurulent vaginal discharge up to 40% of affected mares due to inflammation C ONTAGIOUS Equine Metritis (CEM) is a transmissible venereal disease of equine, causes infertility in mares and spontaneous abortion in pregnant ones. Theetiological agent of CEM is Gram negative bacteria; Taylorellaequigenitalis. In this study,a number of45 clitoral swabswere collected from suspected mares and twenty swabs were fromurethral fossa of stallions. Swabs were kept cool during transportation on Amies with charcoal medium. At the lab, all swabs during 48 hours since they have been collected then cultured on tryptose chocolate blood agar (TBA) plates, and incubated at 37ºC in microaerophilic atmosphere of 5%-10% CO 2 in hydrogen of 7 days. The suspected colonies have been examined for biochemical characters of catalase, oxidase and phosphatase.Allmareswere scannedby ultrasound scanner (Sono Scape sonar), vaginal and/or rectal, checked for the presence of any uterine fluid which may indicate the presence of infection. On the other hand, culture investigations revealed 2 (10%) positive cases among stallions and 5 (11.1%) mare's culture positive for T. equigenitalis. The bacterium is catalase, oxidase and phosphatase positive. The colonies were confirmed by immunofluorescent test and its sensitivity was 100%.Ultrasound examination of three mare's uteri showing pyometra where their lumen measured 40.6-57.3 mm fully filled with echogenic particles. While, the uteri of the other two mares showingendometritis which appearedas an echogenicuterine lumen measured 18.6 mm and 37.6 mm with echogenic particles scattered on it. Biosecurity practices can help in preventingspread of CEM by bacterial culture tests on breeding stallions prior to breeding season. Also, urethral swab for CEM testing should be a stallion's annual breeding exam. According to this study an ultrasound scan at the breeding season to check for the soundness of the mare uteri is strongly recommended.