No abstract

Exposure to early life adversities, as child maltreatment may disturb the whole biological development of a child resulting in different consequences. Among the main underlying mechanisms are epigenetics and DNA methylation. The aim of the study was to access the effects of various factors such as child maltreatment (single or multiple), duration, frequency and age of onset of abuse on DNA methylation. Subjects and methods: 90 children (55 males, 35 females) aged 12-18 years were recruited from adolescent psychiatric outpatient clinics at Al-Hadara University Hospital in Alexandria, Egypt. A Childhood Trauma Questionnaire was used to take the history of child maltreatment. Global DNA methylation was determined by MethylFlash methylated DNA quantification colorimetric kit. Results: Regarding DNA methylation, there was a statistically significant hypomethylation was detected among those who reported exposure to more than one type of child maltreatment than those who reported no exposure or exposure to only one type. Significant difference was also detected between children who were exposed at the age of nine or less and those above 9 years. Moreover, a significant association was found between the duration and frequency of maltreatment in the prediction of DNA methylation. Conclusion: global DNA hypomethylation can be used as a marker to detect exposure to multiple types of child maltreatment. However, it is not about the early child maltreatment alone, but the accumulation of abuse over time and higher frequency of exposure to child maltreatment that causes more global DNA hypomethylation. ARTICLE HISTORY

Background In the coronavirus disease 2019 era, doctors have tried to decrease hospital visits and admissions. To this end, telemedicine was implemented in a non-systematic manner according. The objective of this study was to assess the current knowledge and attitudes of physicians in Alexandria, Egypt, and Punjab, India, toward telemedicine and its ethical and medico-legal issues. Method A cross-sectional study was implemented using an anonymous self-administered questionnaire carried out over two months (July and August 2020). A four-point Likert scale was used to collect data about background knowledge, training in telemedicine and ethical and medico-legal issues in telemedicine practice. Results The questionnaire was completed by 175 Egyptian and 51 Indian physicians from different specialties. A significantly higher percentage of Indian physicians practiced telemedicine than Egyptian physicians during the coronavirus disease 2019 era. Although most physicians had no specific training or licensing to practice telemedicine, most of them practiced telemedicine through their social media accounts. Ethical violations involving waiving patient consent were detected. Significant ethical violations to doctors, for example, blackmail, defamation, hate speech, accusations in a court and violations of privacy, were observed. Indian physicians (39.2%) and Egyptian physicians (24%) thought the penalties should be lower in telemedicine than in traditional practice. Finally, most participants would like to continue using telemedicine after the coronavirus disease 2019 era but with improvements. Conclusions Coronavirus disease 2019 changed the acceptance of telemedicine by physicians. Many ethical and legal issues need to be addressed and clarified using formal training before implementation and standardization of telemedicine services.

Background: In October 2019, 94 patients were admitted into Alexandria Poison Center (APC) with a history of ingestion of Feseekh (salted sh). As a trial to allocate the resources, not all patients were given Heptavalent botulinum antitoxin (HBAT) immediately.The current study aimed to portray the clinical characteristics of the cases, explore the possible relation between these characteristics and necessity of HBAT administration, explore the reliability of MLT, and to establish a clinical guide for management with preservation of resources.Subject and Method: the current prospective study included 94 patients who were admitted to Alexandria Poison Center (APC) in the period from 29 th September to 27 th October 2019. The patients' data was recorded using a checklist that includes: personal data, past medical history, clinical assessment, investigations, treatment and the outcome. The checklist was carried out to assess and follow up each patient. Hospitalized patients were categorized according to symptoms consistent with botulism. The equine HBAT, made by Emergent BioSolutions Canada Inc. (formerly Can gene Corporation) was used in the treatment.Results: HBAT was given to (36.2%) patients only out of the total admission. However, 87.2% of patients were completely cured, whereas 10.6% of patients were discharged with mild neurological sequelea and death occurred only in two cases (2.2%). Conclusion: 63.8% of cases with suspected foodborne botulism toxicity could be managed by supportive treatment only with no need for HBAT.

No abstract