Background: Hepatitis C virus (HCV) is the most commonly encountered blood transmittable hepatitis among cancer patients. Several studies have reported clustering of HCV infections in families or household contacts of infected cases. Data about the epidemiologic aspects of intrafamilial transmission from pediatric cancer patients are scarce and still debated. We aimed to identify the magnitude of horizontal intrafamilial transmission of HCV from infected pediatric oncology patients; its prevalence, risk factors and possible routes of transmission. Methods: One hundred fifty-seven (86 HCV positive, 71 HCV negative) pediatric oncology patients who received treatment and follow-up at Zagazig university Hospital-Egypt and their household family contacts (751) were enrolled in this cross-sectional case-control study. Blood samples were collected from 450 relatives of HCV infected cases (group 1) and 301 household contacts of HCV-negative cases (group 2) for analysis of HCV antibodies and HCV RNA to confirm positivity. Family contacts of HCV-infected cases were interviewed, and close-ended questionnaire was completed for each participant to determine risk factors and possible routes of HCV intrafamilial transmission. Results: Significantly higher HCV prevalence and chronicity rates were documented among relatives of HCV-infected cases as compared with contacts of HCV-negative cases (12.6% and 10.6% for group 1 vs. 7% and 5.3% for group 2, respectively). Risk factors of infection were calculated by univariate and logistic regression analysis among contacts of HCV-infected cases. Female caregivers, particularly mother (OR 5.1, 95% CI: 2–13.5), contact with index cases blood, either directly without using personal protective equipment (OR 7.8, 95% CI: 2.9–23.8) or indirectly through common use of sharps (razors, scissors) (OR 8.9, 95% CI: 3.5–20.5) and nail clippers (OR 2.1, 95% CI: 1.1–5.4) and giving care to infected cases (OR 2.9, 95% CI: 1.3–16.6) represented the real predictors of intrafamilial HCV infection. Conclusions: Intrafamilial transmission of HCV from infected children to their relatives does occur. Parenteral route is the only documented way of transmission either directly or indirectly.

Introduction: Public acceptance, understanding, and trust are some significant challenges facing COVID-19 vaccine coverage. Our study objective was to assess the acceptance rate of COVID-19 vaccination and its predictors among the Egyptian adult population. Methods: An online survey was conducted on 1,053 participants from six randomly selected governorates in Egypt between March and April 2021 using an Arabic self-administrated questionnaire, developed using the Google Form App. Results: Out of the 1,053 participants surveyed, 321 (31.5%) reported that they would accept taking the vaccine when it is available. The main reasons for refusing COVID-19 vaccination were doubt in vaccine effectiveness (80%), lack of trust due to rapid vaccine production (70%), deficiency of information about the vaccine (66%), and fear of vaccine side effects (55%). Regression analysis concluded that previous history of influenza vaccination (p = 0.01), perceived vaccine effectiveness (0.00), vaccine price (p = 0.02), and doctors’ recommendation to take the vaccine (p = 0.03) were the only significant predictors of COVID-19 vaccine acceptance. Conclusions: Low level of COVID-19 vaccination acceptance has been shown among the Egyptian population. To expand vaccination acceptance and coverage, the government should promote vaccine confidence by increasing the availability of clear, precise, and up-to-date information addressing public concerns. It should also provide free vaccinations and should reach out to doctors for promoting the vaccine.

Background: Antibiotics are among the most frequently prescribed drugs worldwide. The overuse and/ or misuse of antibiotics can result in significant consequences as antimicrobial resistance, therapeutic failures, drug toxicities and drug interactions. Since antibiotics are medications that mainly prescribed by physicians, any action aimed at improving use of antimicrobials must necessarily target physicians. Objectives: To assess knowledge, perception and practice of the resident doctors about antibiotic resistance and antibiotic prescription at Zagazig University Hospital and to identify factors affecting them. Methodology: A cross-sectional survey was done at Zagazig University teaching hospital between July and September 2013. Self-administrated questionnaire were used to assess resident doctors' knowledge, perception and practice about antibiotics. Results: From 195 target physicians, 175 agreed to participate. The mean score of knowledge about quiz answer, perception about resistance and perception about prescription were (3.6, 3.8, and 3.2 respectively). The age of the resident doctors was statistically significant affecting answering of the eight quizzes and in the perception about antibiotics resistance (P=0.00) The answering of the eight quizzes, perception about antibiotics resistance and perception about antimicrobial prescription were significantly higher among male doctors than female doctors (P=0.000). There was also significant association between experience (> 2years) and the answering of the eight quizzes, perception about antibiotics resistance (P=0.000). Age groups, answering of the eight quizzes, the perception about antibiotics resistance and perception about antimicrobial prescription were statistically significantly affecting practice of resident doctors about antibiotic prescription ( P<0.05). Conclusion: This study concluded that knowledge of resident doctors and perception about antibiotic prescription was suboptimal. The perception about antibiotic resistance was very high, while doctors' practice in prescribing antibiotic was satisfactory.

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Background and study aim: Hepatic encephalopathy (HE) is a complex and variable neuropsychiatric syndrome that is seen in patients with acute and chronic liver diseases. Diabetes mellitus (DM) is more prevalent in patients with post HCV cirrhosis. Because diabetes mellitus may be associated with delayed gastrointestinal transit and promoting constipation, increasing intestinal bacterial overgrowth and increasing glutaminase activity, we speculated that its presence in patients with HCV related cirrhosis would predispose to and exacerbate hepatic encephalopathy. Patients and Methods: This study included 264 patients with severely decompensated post-HCV cirrhosis, 132 diabetic cirrhotic patients and 132 non-diabetic cirrhotic patients as control group. History is taken for all patients regarding the number of attacks of encephalopathy he experienced in the past three months, the duration of diabetes and the anti-diabetic medication he uses. All patients in the study performed liver function tests, abdominal ultrasound, complete blood count and HBA1c level for diabetic patients as well as psychometric tests for hepatic coma. Results: Diabetic patients had higher frequency of all grades of hepatic encephalopathy mean number of attacks for each patient in the past three months is 1.9±0.3 vs 0.8±0.1 in non-diabetics with unclear precipitating factor in 43% of diabetic patients versus 23% in non-diabetic patients. Patients on oral hypoglycemic drugs represented 14.3% of diabetic patients. Patients with HBA1c >11% were 43% among patients on oral hypoglycemic drugs vs 23% with insulin. Patients on oral hypoglycemic drugs had higher frequency of hepatic coma. The mean number of attacks experienced by each patient rises with increased concentration of HBA1c from 0.8±0.2 at level <7% to 6.4±3for level >11%. The mean number of attacks increased with the duration of diabetes from 1±0.4 for <5 years to 6.4±3.1for >15 years. Conclusion: The frequency of HE was higher in diabetic patients without other obvious precipitating factor. Patients with uncontrolled diabetes and patients on oral hypoglycemic drugs, and those with longer duration of diabetes seem to have higher risk of developing HE.