Medical Specialties Commons^™

Studying The Therapeutic Effect Of Umbilical Cord Stem Cell In Pneumonia Caused By Covid-19, Salama M. El- Shennawy, Abdalla Abo Hassen, Talal Ibrahim Hagag, Asherf I Zahra, Reham Salama, Mariam A. Fouad

Journal of Medicine in Scientific Research

Context: Coronavirus disease (COVID-19) with severe respiratory morbidity and mortality , rapidly spread all over the world, caused by an sever acute respiratory syndrome coronavirus 2 (SARS-CoV-2) varying from mild symptoms to pulmonary fibrosis( Li Z et al.,2020). Mesenchymal stem cells (MSCs) can have a critical role, by promoting the pulmonary parenchyma regeneration and subsequently decreasing the symptoms of COVID-19 and help immune system to act against the virus (WHO, 2020).Aim: to evaluate the efficacy and safety of using stem cell in the treatment of COVID-19patients.Setting and design: We performed this case control study during the period from November 2020 …

Crossed Testicular Ectopia (Cte), A Rare Anomaly: Case Report And Review Of The Literature, Mohammed Rabea Balaswad, Wael Ghorab, Shrief Mebed

Journal of Medicine in Scientific Research

BACKGROUND: A relatively uncommon urogenital anomaly known as crossed testicular ectopia (CTE) can be defined by the emigration of one testis into the opposing inguinal canal, which could possibly be ectopic in the abdominal cavity, inguinal region, or even descend to the opposing hemi-scrotum. Following a review of the literature, the most common classification is to subdivide CTE into three categories based on associations: I, which tends to be associated with inguinal hernia alone; II, which is predominantly associated with persistent mullerian remnants; and III, which is most frequently associated with other anomalies without mullerian remnants. CASE PRESENTATION: We describe …

Voice Quality Assessment In Cases Of Vocal Fold Gaps After Single Growth Factor Injection, Amr Roushdyel Badrawy, Asmaa Abdel Hamid, Israa Eltaweel, Azza Abdel Aziz Azzam

Journal of Medicine in Scientific Research

In severe vocal fold (VF) lesions, deposits of disorganized, thick collagen bundles and little hyaluronic acid (HA) are deposited in the superficial layer of lamina propria (SLP). These changes lead to severe dysphonia and aspiration, which could be complicated by fatal pneumonia. Unfortunately, no specific treatment has been recognized due to unpredictable VF regeneration. Current progress in regenerative medicine has allowed the development of tissue engineering techniques using cells, scaffolds, and growth factors (GFs). Extrinsic GFs application could help in the induction of the regenerative process. The work aims to assess the voice quality after a single GF injection of …

Comparative Study Between Torsional Phacoemulsification And Longitudinal Phacoemulsification In Their Effect On Corneal Endothelium Using Specular Microscopy., Tarek Ibrahim Badr

Journal of Medicine in Scientific Research

Background The cornea is formed of 5 layers, Endothelium is that most posterior layer which is responsible for keeping cornea dehydrated. Loss of corneal endothelium is a sideeffect of many cataract surgeries that may influence postoperative visual outcome of the patients. Our study aims to compare torsional phacoemulsification and longitudinal phacoemulsification in their effect on corneal endothelium using specular microscopy. Patients and Methods We will compare the corneal endothelium parameters (central density of cells & cell loss, alterations in shape & size) afterward torsional phacoemulsification and longitudinal phacoemulsification in this prospective randomized study. 50 eyes with nuclear cataracts in grades …

Ocular Vestibular Evoked Myogenic Potentials In Patients With Single Sided Deafness, Alshymaa Ibrahim Hammad, Sanaa Mahran

Journal of Medicine in Scientific Research

Introduction: Clinically unilateral severe to profound sensorineural hearing loss known as single-sided deafness (SSD). It is defined by severe-to-profound hearing thresholds with a poor word recognition ability. SSD is not uncommonly encountered in otology, their symptoms is hearing loss and often associated with the vestibular system. In SSD otolithic dysfunction may be frequently misdiagnosed and majority of patients affected by cochlear and superior vestibular nerve then inferior vestibular nerve. Otolith damage may be present in patients with SSD because they sharing a membranous structure in addition they have similar receptor cell. The vestibule and cochlea may be impacted by the …

Outcome Of Different Treatment Methods In Patients With Tinnitus And Temporomandibular Joint Dysfunction, Sanaa Mahran Mohamed Andeil, Anwar Moawad Elbatawy, Zienab Shalaby Farid Shalaby

Journal of Medicine in Scientific Research

Introduction: Otology symptoms can be the presenting complain among patients with temporomandibular joint (TMJ) dysfunction. The ear symptoms related to Temporomandibular joint dysfunction are hearing loss and tinnitus. Tinnitus related to TMJ dysfunction is referred to as a type of somatic tinnitus, and it is caused by a musculoskeletal problem, which should be investigated with different methods of treatment to increase the best efficiency of treatment. Objective: Evaluation of different outcomes of different treatment modalities for patients with tinnitus and TMJ dysfunction by using the advantage of Tinnitus Retraining Therapy versus night guard and medication to determine which of these …

Efficacy Of Native T1 Mapping In Differentiation Between Viable And Non-Viable Myocardium In Chronic Ischemia, Diab Mahmoud S, Gad Azza A.H, Abdel Lattif Reda A, Mahrous Mary R

Journal of Medicine in Scientific Research

Background Myocardial ischemia may lead to reversible or irreversible myocardial insult. A precise assessment of myocardial viability (MV) is of clinical relevance to determine the recovery potential of the affected segments. Contrast enhanced cardiac magnetic resonance (CE-CMR) with late gadolinium (Gd) sequences is the gold standard method for MV assessment. Our study tasted the accuracy of segmental native T1 mapping (NT1M) imaging as a non-contrast technique for assessing MV. Methods: Forty-three patients with chronic myocardial ischemia underwent 1.5 T CMR. Imaging protocol includes cine images to assess left ventricular (LV) function, and (LGE) images to detect and estimate the extension …

Clinical Findings And Hematological Parameters In Cases Of Acute Lymphoblastic Leukemia With Thrombocytosis At Initial Diagnosis, Anurag Singh, Sanjay Mishra, Tanya Tripathi, Akanksha Singh, Rashmi Kushwaha, S.P. Verma, U.S. Singh

Journal of Medicine in Scientific Research

Background Acute lymphoblastic leukemia (ALL) is a bone marrow and blood neoplasm involving precursor cells, or lymphoblasts, dedicated to B/T-cell lineages. ALL usually presents with bicytopenia/pancytopenia and thrombocytopenia is the most important key parameter. Thrombocytosis has not been a well-described feature of ALL; hence, this study was planned to investigate the incidence of thrombocytosis at initial diagnosis and its correlation with clinicohematological parameters, immunophenotyping, and cytogenetic study. Aim The aim was to investigate the incidence of thrombocytosis in newly diagnosed cases of ALL and its correlation with clinicohematological parameters, immunophenotyping, and cytogenetics. Materials and methods Medical records of all patients …

Natural Cycle Versus Stimulated Or Artificial Cycle In Frozen–Thawed Embryo Transfer: A Randomized Prospective Trial, Salwa H.B. El-Wakil, Naglaa M. Moharam, Ahmed G.A. El-Seuror

Journal of Medicine in Scientific Research

Objective The goal of this study was to see if there was a difference in pregnancy outcomes between natural cycle frozen–thawed embryo transfer (NC-FET) cycles, artificial cycle–FET cycles, and stimulated cycle (SC)–FET cycles in women with regular menstrual cycles. Patients and methods This prospective randomized clinical study was conducted in Assisted Reproductive Unit (ART), The International Islamic Center for Population Studies and Research, El Hussein Hospital, Al-Azhar University, in the period of September 2019 till August 2020. Results There was a significant increase in immotile sperms in the natural group (P=0.014). Group I had much lower total count and total …

Glyceryl Trinitrate Cream Versus Lateral Sphincterotomy In Management Of Chronic Anal Fissure: A Prospective Randomized Comparative Study, Naser T. Elshamy

Journal of Medicine in Scientific Research

Objective The aim is to compare complications and long-term outcome of two treatment modalities of chronic anal fissure: chemical sphincterotomy by glyceryl trinitrate (GTN) cream and lateral internal sphincterotomy. Background Treatment of chronic anal fissure is achieved by the reduction in the tone of the internal anal sphincter either chemically or surgically. Patients and methods In the period from November 2013 to October 2015, all patients who were admitted to the Department of General Surgery in Shebin Elkom Teaching Hospital complaining of chronic anal fissure were included in the study. According to inclusion and exclusion criteria, patients were selected and …

Saphenous Vein Harvesting With Endoscopy Versus No-Touch Technique: Short-Term Results, Tamer El Bannaa, Mohamed M. Mohamed, Ahmed Zayed, Yasser A. Sadek

Journal of Medicine in Scientific Research

Objective ‘No-touch’ (NT) saphenous vein harvesting maintains vasa vasorum, resulting in less medial ischemic affection, which leads to improved short-term and long-term patency. However, it may also be associated with a higher rate of wound complications. Endovascular vein harvesting (EVH) has a low rate of wound complications but also a tendency toward a lower patency rate. The aim was to compare wound complications and short-term symptomatic relief, which could be an indication of functioning grafts. Patients and methods During a 2-year period (2018–2019), in a nonrandomized prospective study, we monitored patients after coronary artery bypass graft for recurrence of ischemic …

Dental And Oral Manifestations Of Rheumatoid Arthritis: Is It Related To General Disease Activity?, Omnia A. Abubakr, Ali M Youssef, Mohamed A Mohamed, Mohamed A Hamdy

Journal of Medicine in Scientific Research

Background: RA is a chronic immune-mediated systemic disorder; its pathogenesis is complex. Genetic, environmental, hormonal, and lifestyle are the main risk factors. The correlation between oral health and RA is rising. Oral manifestations in RA include temporomandibular joint disorder, secondary Sjögren’s syndrome, xerostomia, and periodontal disease. Previous studies suggest a bidirectional relationship between RA and periodontal diseases. This study aims to detect oral mucosal and dental disease in RA patients and its relation to demographic features, disease activity, and extra-articular manifestation. Patients and Methods: This cross-sectional study included 150 patients with RA allocated into two groups, 75 patients in each …

Histomorphological Spectrum Of Ovarian Neoplasms In A Tertiary Care Centre, Lionel Rohit Mathew, Shalini Karthikeyan, Jaishree Tamilmani, Prema Devi Elangovan, Sridevi Vijayasankar

Journal of Medicine in Scientific Research

Introduction: Ovary is the second most common site of gynaecological malignancies in India and therefore ovarian tumours need to be studied under the microscope for accurate diagnosis and management.

Aim: This study aims to study the spectrum of ovarian tumours and calculate their incidence and age-distribution. Materials and Methods: This study was conducted in the Department of Pathology, Sri Muthukumaran Medical College, Hospital & Research Institute, Chennai, during the year 2022. Results: Among a total of 68 ovarian neoplasms studied, benign tumours (61.7%) were more common and most of the patients were in the fourth decade of life. The commonest …

Assessment Of Outcome Of Cochlear Implant In Auditory Neuropathy Spectrum Disorder Using Speech In Noise Test, Ahmed Mostafa, Sameh Nazmi Siam, Azza Abdel Aziz Azzam, Hanaa Fadel

Journal of Medicine in Scientific Research

Introduction: Children with auditory neuropathy spectrum disorder (ANSD) generally struggle with auditory and language treatment, and cochlear implants' (CIs') outcomes can be unpredictable. environmental noise. The speech discrimination ability is the main complaint of those patients especially in background Objective: Assessment of the ability of young children diagnosed with ANSD who underwent CI in one ear to discriminate speech by using "speech in noise test" with 0 Signal to noise ratio (S/N) and comparing them with matched children with severe to profound sensori-neural hearing loss (SNHL). Methods: The study was conducted on 27 children who received "unilateral" CI of different …

Assessing Serum Ferritin Together With Some Inflammatory Biomarkers In Overweight And Obese Hospital Care Workers At Elgalaa Teaching Hospital And Its Correlation With Metabolic Syndrome, Sahar Mohamed Said Elbayoumi, Hanan Farouk, Heba Abdelaziz

Journal of Medicine in Scientific Research

Obesity is known to be associated with elevated levels of inflammatory markers. One of the major problems associated with morbidity and mortality. The aim of the study was to assess the posing effect of obesity on the levels of serum ferritin, total cholesterol, HDL and LDL, triglycerides, HBA1C, CRP, and Uric acid with CBC, on random well-being colleague females. Patient and methods: 100 adult female health workers were categorized into three entities according to both BMI and waist circumference, as normal, overweight, and obese. Results: increased serum ferritin as an inflammatory marker might correlate to BMI, in juniors; and might …

Expression Levels Of Matrix Metalloproteinase 2 Protein In Preinvasive And Invasive Cervical Lesions And Its Clinicopathological Association: A North Indian Study, Rekha Sachan, Pushp L. Sachan, Ayushi Shukla, Malti Maurya, Munna L. Patel

Journal of Medicine in Scientific Research

Background Matrix metalloproteinase (MMPs) play an important role in development of female genital cancers and metastasis. The aim of this study was to analyze expression levels of MMP2 in various grades of cervical intraepithelial neoplasia (CIN) and squamous cell carcinoma (SCC) of cervix and its association with clinicopathological variables. Patients and methods This prospective study was carried out in a tertiary care center in Northern India over a period of 1 year. A total of 664 participants with gynecological complaints and unhealthy cervix were recruited for colposcopy. Of these, 70 biopsy samples were obtained from higher grade colposcopy lesions, where …

Angiotensin I-Converting Enzyme Insertion/Deletion Gene Polymorphism And Its Association With Diabetic Nephropathy In Type-2 Diabetes Mellitus Patients: An Egyptian Study, Yasmine M. Amrousy, Tamer M. Soliman, Haythem A. Tolba, Aisha Elshimy

Journal of Medicine in Scientific Research

Background Diabetic nephropathy (DN) is one of the most serious complications associated with type-2 diabetes mellitus (T2DM). With variable allele and genotype frequencies, the angiotensin I-converting enzyme (ACE) insertion–deletion (I/D) gene polymorphism has been suggested as a risk factor for DN. Objective The purpose of the study was to find whether ACE I/D polymorphism is associated with DN in Egyptian T2DM patients and its relation to ACE concentration and C-reactive protein quantitative level. Participants and methods A case–control study of 98 T2DM patients was divided into two groups: group 1, T2DM patients without DN, and group 2, T2DM patients with …

Prevalence Of Upper Limb Musculoskeletal Abnormalities In Type 2 Diabetic Patients And Its Relation To Glycemic Control And Associated Factors, Eslam Elsayed Ali Shohda, Amal Emam El-Maghraby, Hadeer Khaled Youssef Elhamid

Journal of Medicine in Scientific Research

Aim of the study: to investigate the prevalence of upper limb musculoskeletal abnormalities and their correlations to glycemic control and associated factors. Methods: A cross-sectional study was conducted at diabetes unit and internal medicine outpatient clinic at Al-ahrar teaching hospital, Zagazig, Egypt. 200 type 2 diabetic patient (T2DM) and 200 non-diabetic control patients of ages > 18 years were enrolled. Rheumatological diseases were excluded. Studied upper limb musculoskeletal abnormalities were Limited joint mobility (LJM), Dupuytren’s contracture (DC), Trigger finger (TF), De Quervain’s tenosynovitis (DQT), Lateral epicondylitis (LE), Medial epicondylitis (ME), Rotator’s cuff tendinitis (RCT) and Carpel tunnel syndrome susceptibility diagnosed by …

A Rare Case Of Fahr’S Disease, Kesar Prajapati, Vishakha Vinod, Sumit Bochiwal

Journal of Medicine in Scientific Research

Fahr’s syndrome, a rare syndrome, is characterized by symmetrical and bilateral intracranial calcifications. A 23-year-old male patient presented with generalized tonic–clonic convulsion and muscle cramps for 1 month. The patient’s blood counts, blood sugar levels, serum sodium, and serum potassium were normal. Computed tomography scan of the brain revealed bilateral symmetrical hyperdensities, suggestive of calcification in globus pallidus, putamen, thalami, caudate and dentate nuclei of the cerebellum, and subcortical white matter of both cerebral hemispheres. The findings were suggestive of Fahr’s disease. His serum ionized calcium levels were low with high phosphate levels (with increased parathormone levels), suggesting the association …

Incidence And Severity Of Pulmonary Hypertension Among Patients With Chronic Kidney Disease, Mamdouh Maher

Journal of Medicine in Scientific Research

Chronic kidney disease (CKD) is a major health problem and is closely linked with cardiovascular disease. Pulmonary hypertension (PH) is considered a common comorbidity in CKD patients. In all, 100 patients were included in our study. Transthoracic echo Doppler study was performed to measure pulmonary artery systolic pressure based on tricuspid jet. The prevalence of PH in CKD patients in our study was 60%; prevalence and severity had significant association.

The hemodialyzed group showed a higher prevalence of PH with a more severe PH.

Our study had provided evidence that PH is a common comorbidity in CKD patients and is …

Oral Mucosal And Dental Affection In Patients With Systemic Lupus Erythematosus: A Clinical Survey, Omnia A Abubakr, Ali M Youssef, Mohamed A Mohamed, Mohamed A Hamdy

Journal of Medicine in Scientific Research

Background: SLE is a chronic autoimmune disease predominantly affecting young females. Systemic involvement along with variable clinical presentations characterizes SLE. Various oral and dental manifestations have been described in SLE that include oral ulcerations, candida infection, and periodontal disease. We aimed to detect oral mucosal and dental disease in SLE patients and its relation to demographic features, general disease activity, and the extra-articular manifestation. Patients and Methods: 80 patients with SLE were included in this cross-sectional study. Patients were allocated into 2 groups, 40 patients in each group, according to SLE disease control with immunosuppressive medications: group A included patients …

Outcome Of Suture Annuloplasty (De Vega) Versus Ring Annuloplasty For Functional Tricuspid Valve Regurgitation Concomintant With Mitral Valve Surgery, Tarek Elshazly Omran, Ashraf Zahra

Journal of Medicine in Scientific Research

Background: The optimal surgical technique for functional tricuspid regurgitation (TR) repair is still a topic for ongoing research. The DeVega technique is still used frequently in developing countries. Thus, this study aimed to compare the outcomes of tricuspid valve repair using DeVega vs. ring annuloplasty for managing severe functional TR during mitral valve surgery. Methods: This retrospective chart review included 66 patients. The study included patients with simultaneous tricuspid valve repair during mitral valve intervention. The patients were recruited from 2018 to 2022. The study had two groups: the first group included 50 patients who underwent the DeVega technique (Group …

Yersinia Infection In Acute Appendicitis In Children In Shebin Elkom Teaching Hospital, Salama M. El- Shennawy, Khaled S.A. Elkelany, Mariam A. Fouad, Shimaa M.M Bebars, Faisel Goda, Abdelghany Abdelsattar Aish

Journal of Medicine in Scientific Research

Background: Yersinia enterocolotica is being recognized as an important bacterial cause of acute gastrointestinal infection. The association of yersinia entrocolotica infections with acute appendicitis has been suggested (Tae Joon Son et. al, 2009). The aim to ascertain whether yersinia entrocolotica is a possible infectious agent in appendicitis in Shebin Elkom. We try to support or to deny this suggestion. Methods: A prospective randomized study was done to 48 patients admitted to surgical department from outpatient clinic of Shebin Elkom Teaching Hospital over 14 months from January 2020 to March 2021The purpose and nature of the study were explained to all …

Study Of Arterial Blood Gases In Different Stages Of Chronic Liver Diseases, Moheb W. Elfaizy, Therese S. Ghatas

Journal of Medicine in Scientific Research

Background Early detection of arterial gas abnormalities and acid–base disturbances in patients with chronic liver disease is essential to improve prognosis on the basis of pulmonary and liver diseases. The aim of the current study was to detect arterial blood gas changes, acid–base disturbances, and prevalence of hepatopulmonary syndrome (HPS) in different classes of severity of chronic hepatic disease for achieving a higher survival rate. Results Patients with hypoxemia represented 38 (33.6%) cases: three (15.7%) of 19 patients in group A, 16 (33.3%) of 48 patients in group B, 12 (34.2%) of 35 patients in group C, and seven (63.6%) …

Short-Term Results Of Off-Pump And On-Pump Aortic Arch Debranching During Type I Hybrid Arch Repair: A Single-Center Experience, Ahmed S. Emara, Hussein A. Zaher, Mahmoud F. El-Safty, Mohamed A. El-Badawy, Mohamed A. El-Hady, Mostafa M. Abdalraouf

Journal of Medicine in Scientific Research

Background Compared with off-pump surgeries, cardiopulmonary bypass (CPB) is associated with a high systemic inflammatory response and with substantial myocardial injury, especially in high-risk subgroups. Every effort should be exerted to minimize the role of CPB without affecting the safety and outcome. Classically, aortic arch surgeries were done using CPB and deep circulatory arrest together with cerebral brain protection strategies. With the development of endovascular techniques, the role of CPB decreased. Management of aortic arch pathologies carries special needs, specifically rerouting of the great vessels and preparing a landing zone. Objectives To assess the effectiveness and safety of off-pump aortic …

Mitral Valve Repair For Mitral Regurgitation In Pediatrics And Children: Initial Experience, Waleed El-Awady

Journal of Medicine in Scientific Research

Introduction Mitral valve repair in pediatrics has been slow because of the great variety in congenital mitral valve malformations and the still unknown growing effect over the mitral valve. The aim of this study is to evaluate the early and mid-term results in surgical repair of mitral valve regurgitation in pediatrics and children. Patients and methods A total of 16 patients had mitral valve repair for mitral regurgitation (MR) between November 2016 and December 2020 at the National Heart Institute. There were seven (43.75%) males and nine (56.25%) females. The mean age was 7.5 years (5 months and 14 years). …

Fontan Procedure With Extracardiac Conduit In Pediatrics And Children: Short-Term Results, Amal Younan, Hanan Hassan, Waleed El-Awady

Journal of Medicine in Scientific Research

Introduction The concept of Fontan circulation was first clinically introduced in 1971. Technical modifications have been advocated with the concept of total cavopulmonary connection, introduced in the late 80s. Recently, an extracardiac conduit to divert inferior vena cava flow to the pulmonary arteries has been advocated, and it affords excellent palliation for patients with various forms of the anatomic or functional single ventricle. Patients and methods From September 2019 to August 2021, 12 patients (five males and seven females) with a mean age of 10.7 (6–15) years underwent a Fontan procedure with extracardiac conduit at the National Heart Institute. The …

Combined Macular Detachment And Macular Massage In Large Macular Hole, Hazem A. Elnashar

Journal of Medicine in Scientific Research

Background Over the past two decades, the surgical treatment of full-thickness macular holes (MHs) has advanced significantly, with current hole closure rate increasing more than 95%. Aim To assess the visual and anatomical outcomes of combined macular detachment and macular massage techniques for large MHs. Patients and methods The current work involved 12 eyes of 12 patients with large full-thickness idiopathic or traumatic MH. All participants were subjected to full ophthalmic assessment and measurement of best-correctable Snellen visual acuity, intraocular pressure, fundus photograph, and spectral-domain ocular coherence tomography at preoperative and postoperative periods. All surgeries were done by two surgeons …

Relation Of Multimineral-Vitamin D Supplementation And The Risk Of Preeclampsia, Abear El Shabacy, Mohamed A. El-Naggar, Mohamed S. A. Emarah, Osama S. Eltaher, Saher H. Qushwa

Journal of Medicine in Scientific Research

Background The objective of this study was to determine the favorable effects of multimineral-vitamin D supplementation on pregnancy outcomes among women at risk for preeclampsia. Patients and methods This randomized double-blind controlled clinical trial was conducted among 46 women at risk for preeclampsia at 27 weeks of gestation, with positive roll-over test. Pregnant women were randomly assigned to receive either the multimineral-vitamin D supplements (n = 23) or the placebo (n = 23) for 9 weeks. Multimineral-vitamin D supplements were containing 800 mg calcium, 200 mg magnesium, 8 mg zinc, and 400 IU vitamin D3. Fasting blood samples …

Role Of Vaginal Progesterone On Uterine Artery Doppler Changes In Pregnant Women At Risk Of Preterm Labor, Ahmed A. Badr, Ibrahim M. El-Maghraby

Journal of Medicine in Scientific Research

Background Progesterone is increasingly being used in women at high risk for preterm labor and for maintenance tocolysis. Ultrasound evaluation of uterine in pregnant women in the second trimester of pregnancy can be a predictor of birth complications. Objective To study the effect of vaginal progesterone on uterine by doppler sonography among women in the second and third trimesters of pregnancy who are at risk of preterm labor. Patients and methods A prospective study was carried out on 60 patients attending Obstetrics and Gynecology Department, Menoufia Teaching Hospital, Menoufia, Egypt, during the period from March 2019 to March 2020. The …